ABSTRACT
It is not easy being a general practitioner in today's NHS. This is evidenced by the fact that it is becoming difficult to recruit GPs in some areas, that there are high rates of stress, divorce, alcoholism and psychiatric illness among GPs and that general practice is often accorded a relatively low status within the medical profession (McKevitt et al., 1996;Caplan, 1994:1261–3; Sutherland and Cooper, 1992:1545–8). Contributing to these problems is the fact that GPs often face particularly demanding ethico-legal dilemmas arising from the special characteristics of the job itself. These problems concern four factors characteristic of much general practice. First, GPs have long-term relationships with patients unlike most clinicians who work in acute care. Second, GPs treat families whose members sometimes have conflicting interests and demands. Third, GPs have much less opportunity for the collaborative discussion and debate which is essential for rational decision making about ethical and legal dilemmas in medicine. And, finally, GPs often face unrealistic moral demands as regards their role as primary health carers.
