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Biomedical subjects

A Braunack-Mayer

Publications and source records attributed to A Braunack-Mayer.

8 recordsLinked to original sources
PubMed2006

Conflicts of interest in divisions of general practice.

Community-based healthcare organisations manage competing, and often conflicting, priorities. These conflicts can arise from the multiple roles these organisations take up, and from the diverse range of stakeholders to whom they must be responsive. Often such conflicts may be titled conflicts of interest; however, what precisely constitutes such conflicts and what should be done about them is not always clear. Clarity about the duties owed by organisations and the roles they assume can help identify and manage some of these conflicts. Taking divisions of general practice in Australia as an example, this paper sets out to distinguish two main types of conflicts of interest, so that they may be more clearly identified and more effectively managed.

Australia↗
PubMed2005

What makes a good GP? An empirical perspective on virtue in general practice.

This paper takes a virtuist approach to medical ethics to explore, from an empirical angle, ideas about settled ways of living a good life. Qualitative research methods were used to analyse the ways in which a group of 15 general practitioners (GPs) articulated notions of good doctoring and the virtues in their work. I argue that the GPs, whose talk is analysed here, defined good general practice in terms of the ideals of accessibility, comprehensiveness, and continuity. They regarded these ideals significant both for the way they dealt with morally problematic situations and for how they conducted their professional lives more generally. In addition, I argue that the GPs who articulated these ideals most clearly were able to, in part, because they shared the experience of working in rural areas. This experience helped them to develop an understanding of the nature of general practice that their urban colleagues were less able to draw on. In that sense, the structural and organisational framework of general practice in rural areas provided the context for their understanding of ideals in general practice.

Adult↗
PubMed2004

Doctors' views about the importance of shared values in HIV positive patient care: a qualitative study.

Robert Veatch has proposed a model of the doctor-patient relationship that has as its foundation the sharing of values between the doctor and the patient. This paper uses qualitative research conducted with six doctors involved in the long term, specialised care of HIV positive patients in South Australia to explore the practical application of Veatch's value sharing model in that setting. The research found that the doctors in this study linked "values" with sexual identity such that they defined value sharing, in part, as a shared set of values and beliefs about sexual identity and practices. They voluntarily identified themselves as either homosexual or heterosexual and they regarded the relation between their own sexual identity and that of their patients as important for the provision of quality care. None of the doctors thought that value sharing, in the way they defined it, was essential to the clinical relationship, but the homosexual doctors attributed a greater degree of importance to it than their heterosexual colleagues.

Ethics, Clinical↗
PubMed2001

Casuistry as bioethical method: an empirical perspective.

This paper examines the role that casuistry, a model of bioethical reasoning revived by Jonsen and Toulmin, plays in ordinary moral reasoning. I address the question: 'What is the evidence for contemporary casuistry's claim that everyday moral reasoning is casuistic in nature?' The paper begins with a description of the casuistic method, and then reviews the empirical arguments Jonsen and Toulmin offer to show that every-day moral decision-making is casuistic. Finally, I present the results of qualitative research conducted with 15 general practitioners (GPs) in South Australia, focusing on the ways in which these GP participants used stories and anecdotes in their own moral reasoning. This research found that the GPs interviewed did use a form of casuistry when talking about ethical dilemmas. However, the GPs' homespun casuistry often lacked one central element of casuistic reasoning--clear paradigm cases on which to base comparisons. I conclude that casuistic reasoning does appear to play a role in every-day moral decision-making, but that it is a more subdued role than perhaps casuists would like.

Adult↗
PubMed2001

Application of the privacy principles to general practice.

BACKGROUND: There are escalating requirements for general practitioners to comply with recognised privacy principles. With amendments to the Commonwealth Privacy Act (1988) imminent, there is an urgent need to formulate methods for applying these principles to general practice. OBJECTIVE: The article provides an explanation of the origins of the privacy principles and a simple self audit which general practitioners can use to assess the extent to which their usual practices conform with them. DISCUSSION: A careful review of the principles indicates that new measures will be needed before most general practices will be able to approach required standards of conduct. Practical strategies for achieving best practice are discussed and challenges confronting general practices in applying the principles are canvassed. Ethics committees should be used more often to provide independent review of practice policies and proposals to use patient information in new ways. General practitioners can expect increasing scrutiny and debate concerning confidentiality. In order to maintain patient trust in GPs as responsible data custodians, the privacy principles can be seen as a quality improvement tool.

Australia↗
PubMed2000

Handling information. Some ethical issues.

BACKGROUND: General practitioners are increasingly involved in a range of activities which require the use of data from patients' case notes. These activities include audit, evaluation and research. Any use of patient data has the potential to breach patient confidentiality and privacy. However, at present the requirements in terms of obtaining informed consent vary. Research is usually acknowledged as requiring consent, but this is not always the case for audit and evaluation activities. OBJECTIVES: The aim of this paper is to define audit, evaluation and research activities in general practice and to clarify the ethical issues involved in using patient data for these purposes. We argue that the ethical issues raised by accessing patient case notes are similar for all of these activities. DISCUSSION: The ethical obligation to obtain patient consent prior to accessing or using patient information is the same for many general practice audit, evaluation and research activities. However, the avenues for obtaining ethical clearance may be hard to access for GPs. In addition, the special relationship between patients and their GP and the requirements specified by health research ethics committees such as de-identification of case notes create problems for these activities in general practice.

Australia↗
PubMed2000

Handling information ethically. Some strategies for discussion.

BACKGROUND: A lack of consensus currently exists about which uses of patient data require informed consent or review by a human research ethics committee. However, any use of patient data other than for clinical care, requires the consent of the patient. OBJECTIVE: The aim of this paper is to discuss strategies for strengthening current practices regarding the use of patient information in general practice research, evaluation and audit. DISCUSSION: Increasing community discussion and debate with respect to the use of patient data for research and evaluation is a pressing issue. Divisions of general practice are well placed to lead in this debate given the extent of community representation in many divisions' activities. Development of guidelines for use by those undertaking research and evaluation activities in general practice, based upon the Privacy Principles, will ensure a high standard of protection for patients. Community based Human Research Ethics Committees may be an appropriate way of providing education and training as well as a review of general practice research and related activities.

Australia↗