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Journal of Medical Ethics 2001;27:98–103

What makes a problem an ethical problem?
An empirical perspective on the nature of ethical problems in general practice
Annette Joy Braunack-Mayer University of Adelaide, Australia

Abstract
Whilst there has been considerable debate about the fit between moral theory and moral reasoning in everyday life, the way in which moral problems are defined has rarely been questioned. This paper presents a qualitative analysis of interviews conducted with 15 general practitioners (GPs) in South Australia to argue that the way in which the bioethics literature defines an ethical dilemma captures only some of the range of lay views about the nature of ethical problems.
The bioethics literature has defined ethical dilemmas in terms of conflict and choice between values, beliefs and options for action. While some of the views of some of the GPs in this study about the nature of their ethical dilemmas certainly accorded with this definition, other explanations of the ethical nature of their problems revolved around the publicity associated with the issues they were discussing, concern about their relationships with patients, and anxiety about threats to their integrity and reputation. The variety of views about what makes a problem a moral problem indicates that the moral domain is perhaps wider and richer than mainstream bioethics would generally allow.
(Journal of Medical Ethics 2001;27:98–103)
Keywords: Empirical ethics; general practice; qualitative research Introduction
There has been a spirited debate in recent years about the relationship between real life moral decision making and the forms, styles and content of reasoning used in bioethics. On the one hand, moral theorists and, in particular, bioethicists, present the view that their theories of moral reasoning provide a more rational and ordered

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