General practitioners' (GPs) preference for quick, "just-in-time" resources has shaped ethical decision-making in primary care practice. While this preference is understandable given the many time constraints placed upon GPs, it has led to an over-reliance on professional standards or the law as the primary source of ethical guidance, with guidelines being treated as prescriptive 'rules' rather than tools for critical ethical reflection. This approach potentially compromises the ethical standard of care when complex cases require nuanced consideration beyond what guidelines can provide. In some cases, consulting a guideline will not always be enough to satisfy robust ethical standards.
General practice requires more opportunities for ethical reflection that go beyond guidelines. We argue for integrating bioethics knowledge from more acute settings into primary care practice, enabling practitioners to reclaim (when needed) active responsibility for ethical decision-making in their practice. This may include more opportunities for GPs to engage in structured ethical deliberation and reflection with colleagues, as well as a critical look at the potential for clinical reasoning to be conflated with ethical deliberation. As GPs are tasked with an increasing range of genomic interventions with potential for ethical complexity, the solution is not additional guidelines. In this presentation we will explore novel approaches to responding to the ethical issues that arise as genomics expands into primary care.