We greatly appreciate Dr Lennon’s thoughtful comments and careful reading of our paper. We agree that in diverse societies such as ours, people’s values and morality, larger issues of professional ethics, and the law of the community are sometimes in conflict. How we address this reality in our work as family physicians is what we conceptualize as family medicine ethics.
In our opinion, ethics always involves action and behavior, in addition to thoughts and beliefs. As we wrote in our paper, family medicine ethics means answering the question: “What, all things considered, should happen in this situation?—at every clinical encounter over the course of the patient-doctor relationship.” We believe that applying the steps outlined in our approach—identifying issues and stakeholders, gathering data, and performing analyses from a variety of perspectives—can help determine which of these “all things” are most important in a particular case and lead to the most appropriate actions and behaviors in the complex situations we face in real life.
We again thank Dr Lennon for his letter and encourage him to think and write more on these topics. We encourage others to reflect and respond on family medicine ethics as well.