Beneficence in general practice: an empirical investigation

Objectives-To study and report the attitudes of patients and general practi tioners (GPs) concerning the obligation of doctors to act for the good of t heir patients, and to provide a practical account of beneficence in general practice. Design-Semi-structured interviews administered to GPs and patients. Setting and sample-Participants randomly recruited from an age and gender s tratified list of GPs in a geographically defined region of South Australia . The sample comprised twenty-one general practitioners and seventeen patie nts recruited by participating GPs. Results-In practice, acting for the good of the patient not only accommodat es the views of patients and GPs on expertise and knowing best, but also re sponds to the particular details of the clinical situation. Patients had a complex understanding of the expertise necessary for medical practice, desc ribing a contextual domain in which they were expert, and which complemente d the scientific expertise of their GPs. General practitioners identified m ultiple sources for their expertise, of which experience was the most signi ficant. The role of the GP included responding to individual patients and p articular clinical problems cmd ranged from the assumption of responsibilit y through to the proffering of medical advice. Conclusion-This study found that GPs acting for the goad of their patients cowered a variety! of GP actions and patient preferences. Beneficence was n ot justified by presented patient vulnerability! or the inability of patien ts to understand medical problems, but furthered through a recognition of t he different areas of expertise contributed by both parties to the consulta tion.