ABSTRACT
There may seem to be enough to do as a doctor, making clinical decisions at speed, without complicating things by asking ‘whether something broadly accepted is really right’, or ‘what is really best’ for this particular patient. Sometimes, however, those questions won’t seem to go away, because the implications of the decision go beyond medicine, or because there is genuine conflict to be resolved. For instance, someone may ask the doctor to do something that the doctor thinks is
wrong or cannot legally do. A diagnosis or a treatment may mean that someone can no longer do their job. Two patients may present at once with a shared complaint but different points of view about the best solution. Things that were hidden or unmentionable in families may suddenly need to be discussed, or members of that family may disagree about what should be done. The doctor may discover something that he or she feels should be reported to police or social services. All these problems may pile onto the doctor’s desk in the same day.
