While it is well recognised that ethical issues arise in general practice, much less is known about how general practitioners (GPs) identify an ethical issue, how they respond to them and what support they need. We are conducting a systematic scoping review to examine GPs' experiences with ethical decision-making tools, consultation processes, and educational support. This review uses narrative synthesis to analyse key themes emerging from both quantitative surveys and qualitative studies. It illuminates theoretical tensions between practitioners' expressed needs and available support mechanisms while advancing our understanding of ethics in primary care practice.
Our analysis reveals how practitioners currently navigate ethical challenges, what resources they find most valuable, and gaps between what is available and what practitioners need. We present a preliminary framework categorising types of ethics support valued by GPs. Preliminary evidence suggests that practitioners prefer brief and accessible, ‘just in time’ resources and guidelines endorsed by professional bodies, but current systems are inadequately designed to meet these preferences, particularly in complex cases requiring nuanced ethical deliberation.
The review informs recommendations for developing more responsive ethics support approaches that better align with the realities of general practice. This work contributes to understanding how to bridge the gap between theoretical ethics resources and clinical decision-making in primary care. Future research should focus on developing and evaluating targeted ethics interventions for primary care settings.