Practical Ethics for General Practice

Front Cover
General practice provides the first point of contact to medical care for patients across the world. GPs have obligations to patients in their care, to the government for responsible use of resources, and to communities for the standard of health services provided. Ethics is at the heart of health services, dealing with fundamental questions about what ought to be valued, and why. The two disciplines inevitably impact upon each other, and this book brings them together to focus on practical ethics for general practitioners. In this update of a successful first edition, the authors aim to: help GPs appreciate the ethically significant nature of general practice, drawing attention to the ethical complexity of apparently mundane and everyday experience; present a thoughtful and thought-provoking account of the moral foundations of general practice, exploring how moral concepts such as trust, beneficence, respect for autonomy, and fairness take on unique meanings in the general practice setting; and to discuss some specific ethical issues in detail, offering solutions that are practical as well as ethically sound. The focus is on practice throughout, ensuring through real cases and discussions with practitioners that the book is not abstract and esoteric in its discussion of philosophical principles, but that it is applicable in the real world of the doctor's surgery. The authors guide their readers through basic approaches to ethical reasoning and use of a practical ethics analysis framework suitable for use in all ethical dilemmas in medicine. Themes covered include the authors' research-based account of trust and the doctor-patient relationship, acting in the patient's best interests, confidentiality, making decisions with patients, beginning and end of life issues, treating children and adolescents, and role conflicts in general practice.
 

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Contents

1 General practice and ethics
1
2 Ethical reasoning and general practice
9
3 Trust and the doctorpatient relationship
25
4 Difficult relationships with patients
41
5 Confidentiality in general practice
53
6 Beneficence or does the doctor know best?
69
7 Justice and resource allocation in general practice
93
patient autonomy in general practice
113
9 Ethical issues at the beginning of life
135
10 Ethical issues in the care of children
153
11 Ethical issues at the end of life
169
12 Role conflicts in general practice
189
virtues in general practice
211
Index
225
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About the author (2009)


Wendy Rogers leads the teaching of ethics, law and professionalism in the medical program at Flinders University. In 2007, she received a national Carrick award for her teaching in this area. Her current research projects include gender equity in health research, the ethics of influenza pandemic planning, and issues raised by biological donations. Wendy was a founding director of the Ethics Centre of South Australia, served as the Co-coordinator of the International Network on Feminist Approaches to Bioethics from 2006-8 and serves on the editorial boards of journals including Bioethics, International Journal of Feminist Approaches to Bioethics, Health Expectations and BMC Biomedical Ethics. She is a member of the Medical Board of South Australia, and is a regular commentator in the media on a range of bioethical issues.
Annette Braunack-Mayer teaches medical and public health ethics and qualitative research methods at the University of Adelaide. Her current research projects include the ethics of influenza pandemic planning, consent and privacy in public health research, and community involvement in decision-making about clinical and public health practice. She is also a Consultant Ethicist to Adelaide Health Technology Assessment and the Australia and New Zealand Horizon Scanning Network. With Wendy, Annette was a founding director of the Ethics Centre of South Australia, and she currently chairs the Centre's Board of Management.

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