General practitioners’ ethical decision-making: Does being a patient themselves make a difference?

Abstract

There is very little literature on the actual decision-making frameworks used by general practitioners with respect to ethical issues and virtually none on the impact of personal experiences of illness on this. This study aimed to investigate what these frameworks might be and if and how they were altered by doctors’ own illness experience. Twenty general practitioners were recruited, 10 having had a previous serious medical illness and 10 having no such history. They participated in a semi-structured interview, including case vignettes, recorded and analysed using qualitative thematic analysis. Being a patient themselves altered general practitioners’ decision-making by enhancing physician empathy, increasing ease at discussing difficult topics, having a greater willingness to support patient choice and a wider ability to provide a greater diversity of therapeutic strategies, with the role of empathy being the most noticeable difference between the groups. Doctors who had not had a severe personal illness showed difficulty in anticipating how this might change their decision-making. Virtue ethics was most commonly used for decision-making by both groups. There was considerable divergence of opinion on the ethics and usefulness of self-disclosure of personal illness in both groups of doctors. These findings have implications for the teaching and learning of medical ethics at both undergraduate and postgraduate level.