Should GPs avoid making ethical judgements?

We were aware that publications in the clinical ethics literature suggested that conscience and compassion were problematic concepts in health care for clinicians.1,2 While these address compassion and conscience, they are possibly interpreted as clinicians ought not to make ethical judgements, or enact human values beyond those strictly stipulated by the job. Personal conscience (at least with regard to conscientious objection) has been challenged on the basis that ethical deliberation should not take place in the clinical encounter and clinicians should offer whatever the governing or regulatory bodies have rightly determined to be beneficial or the correct approach. The values ascribed to clinicians, even with respect to compassion, have been challenged as unrealistic and too burdensome in the stressed healthcare workplace.1,3 One interpretation of these two positions is that it is unfair to patients and unfair to GPs (or other clinicians) for any ethical deliberation to take place at the bedside or in the consulting room. Clinicians should do as asked by the patient and the governing or regulatory bodies in line with established professional duties. If they do more or less it is in their own time and at their own risk. GPs may also unconsciously avoid making ethical judgements, by deferring completely to patient choice, by accepting certain moral positions as self-evident, by equating the law with morality, and by conflating moral and empirical questions.