• Aust Fam Physician · Dec 2012

    The informal curriculum - general practitioner perceptions of ethics in clinical practice.

    • Nancy J Sturman, Malcolm Parker, and Mieke L van Driel.
    • University of Queensland, Brisbane, Queensland, Australia. n.sturman1@uq.edu.au
    • Aust Fam Physician. 2012 Dec 1; 41 (12): 981-4.

    BackgroundAustralian medical students should graduate with an understanding of the principles of medical law and ethics, and their application to clinical settings. Although student perspectives have been studied previously, the teacher experience of ethical issues also needs to be understood, particularly in the general practice setting.MethodsInterviews were conducted with a convenience sample of 13 general practitioner teachers. They were asked to reflect on common and/or important ethical issues in their day-to-day practice. An inductive thematic analysis of the data was performed by two investigators, who reached a consensus on major themes using an iterative, dialogic process.ResultsParticipants reported negotiating ethical issues frequently. Major themes included patient-doctor relationships, professional differences, truth-telling, ethically 'grey' areas and the personal demands of ethical decision making.DiscussionGeneral practitioners in this study describe sometimes needing to apply judgement and compromise in situations involving legal or ethical issues, in order to act in the best interests of patients and to successfully negotiate the patient-doctor relationship. Students learning in this clinical context may perceive mixed messages and ethical lapses in these challenging 'grey' areas. The ethical acumen and emotional resilience of both students and clinical teachers may be enhanced by ongoing reflective discussion with colleagues.

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