Ethics of the ordinary: a class response

Abstract

In a previous issue of the BJGP , Papanikitas and Toon use a fictional narrative to illustrate the ethical components of an ordinary consultation.1 We discussed the narrative as a class as well as the questions posed by the authors, and would like to showcase our discussion as a way to decrypt some of the moral decisions and value judgements in this case. As a set of signposts to the ethical principles we have used Gillies’ InnovAIT paper.2 This paper sets out key ethical frameworks in relation to RCGP curriculum statement 3.3 on ethics and values-based medicine.3 The class consisted of five qualified GPs, one senior house officer in medicine, one bioinformatics graduate, and one researcher for a think-tank. The class were all taking part in an optional MSc module in ethics law and professionalism as part of an MSc degree in primary healthcare or a Master of Public Health degree at King’s College London. We conducted the discussion by Chatham House Rule, so all authors contributed, but no one voice is identified here. The class facilitator was Andrew Papanikitas, one of the authors of the previous BJGP narrative. We are all too aware that our discussion is not comprehensive and would welcome correspondence, either with us directly (via the corresponding author) or in the pages of this Journal. The scenario is one where the last patient on a Friday afternoon asks for a private referral to a clinic for consideration of bariatric surgery. We note that the patient would not qualify for an NHS referral, and that the GP in the scenario is in a hurry to get to a social engagement. The authors ask how the doctor reconciles his ‘legitimate’ (class emphasis) plans for an evening out with the needs of his patient. In discussion …