Dr Andrew Papanikitas
Bioethics scholarship and moral deliberation in UK General Practice
This PhD research project looks at the combined ethical, social and legal understandings, regulations and practices that inform how UK General Practitioners identify and deal with ethical issues in the context of primary care.
Chief investigator background
Activities in medical ethics
Prizes and grants
What is the purpose of the research project?
PhD Project information
This project will address the questions: What issues generate ethical conflict for General Practitioners (GPs)? How are these ethical conflicts resolved or reconciled? How does this affect and how is it affected by curricula, guidelines and academic research into law and ethics?
The study aims:
1. To discover, using qualitative methods, the explicit and implicit ethical decision-making strategies used by UK GPs as well as those suggested by stakeholders involved with UK Primary Care Ethics.
2. To use this data to further understand how such decisions are made and why different strategies are used and how moral principles, professional guidelines and laws are applied and reconciled when they conflict.
3. To contrast the approaches used by a sample of UK GPs and relevant stakeholders with ethical frameworks identified in the literature on General Practice ethics.
4. It is anticipated that this research will illustrate different perceptions and strategies of ethical decision-making by UK GPs, and that this will help lawyers and policymakers shape future laws, codes of practice and guidelines for situations associated with ethical dispute, conscientious objection and moral ambiguity.
Who is conducting the research?
The research is carried out by Andrew Papanikitas, who is a part-time practising GP and has had training in Medical Law and Ethics as well as qualitative research methods. He is supervised by Professor Alan Cribb and Professor Sharon Gewirtz (Department of Education and Professional Studies).
Who is funding the research?
This study is currently self-funded by Andrew Papanikitas.
What are the aims of the interviews?
Discussion about ethical decision-making in Primary Care, which we hope will be useful to everyone participating
To produce examples of dilemmas and insights into their resolution
To help frame interview and focus group research which is taking place in parallel to these stakeholder interviews
Who has reviewed the study?
This Study has been approved by the Royal Free Hospital NHS Research Ethics Committee (ref. no: 09/H0720/126)
Possible benefits of participation
GPs at all stages of training are encouraged as part of appraisal and revalidation to reflect upon the ethical problems which may arise in the context of primary care. It is also hoped that all participant stakeholders will have the opportunity to contribute to and influence research findings that may lead to policy recommendations and academic contributions to GP-education and primary care ethics.
Will the information be kept confidential?
In accordance with the 1998 Data Protection Act, all information collected during the research will be kept confidential. Transcripts of the interviews will be anonymised and any identifying details removed. Some broad demographic questions may be asked (e.g. practice setting, qualifications in medical ethics) to aid interpretation. Recordings and transcripts will be stored securely in a research office. At project completion, audio recordings will be destroyed; transcripts will be stored for 7 years from project completion. Consent forms will be kept securely for the same period. If a participant feels, at the time or afterwards, that they do not want specific statements to be used in reports I will omit these from the transcript. However, I cannot withdraw data after it has been included in a submission, presentation or publication (which will take place a minimum 60 days after participation). The only exception to this would be the disclosure of clearly unacceptable or illegal practice.
What will happen to the results of the research study?
I will publish papers in academic journals and give conference presentations. The results will be presented as a PhD Thesis, which in turn may be published as a book. Verbatim quotes may be used, but participants will not be identifiable in any report, publication or presentation. Participants may elect to receive a summary of findings toward the end of the study, which will be placed on the project website.
To receive more information about any of the above, please email firstname.lastname@example.org
Chief Investigator: Academic and Professional Background
BSc (Hons) in the History of Medicine, UCL/UMDS 1999
MA (Merit) Medical Law & Ethics, King’s College London 2002
MBBS (Medical Degree), King’s College London 2003
Postgraduate Diplomas in Philosophy & History (WSAL) & Child Health (RCPCH)
Membership of the Royal College of General Practitioners (August 2008), Works as part-time General Practitioner
Royal Society of Medicine Trainees Committee: 2003 to 2009
Royal Society of Medicine Open Section Council: 2004 to present http://www.rsm.ac.uk/academ/secopen.php
Royal Society of Medicine General Practice Section Council: 2009 to present http://www.rsm.ac.uk/academ/secgp.php
Royal College of General Practice, North and West London Faculty Board: 2010 to present
BMA Junior Doctors’ Committee, Chairman of Oxford JDC and Representative for Oxford on National JDC 2007-2008
King's College London Association Council, King’s College London 2007-Present
3. Activities in Medical Ethics
Steering Group Member: Special interest group in Primary Care Ethics (Convened by Peter Toon with endorsement of the RCGP and the Royal Society of Medicine)
Co-lead, Module on ethics law and professionalism (with Dr Kalwant Sidhu), MSc in Primary Healthcare/MPH, Department of Primary Care and Public Health Sciences, Kings College London 2010-2012
Facilitator in Ethics and inter-professional education (IPE), IPE course, Health Schools, King’s College London, 2010-present
Convenor (With Paquita De Zulueta and John Spicer), Ethics at the Coalface course, RCGP North and West London Faculty 2010-present http://www.rcgp.org.uk/pdf/events/flyer/NWL%20Ethics%20Workshop%20Flyer.pdf
Ethics Editor, London Journal of Primary Care, 2011- Present
Co-author (with Professor Brian Hurwitz), ethics e-learning for general practice session on confidentiality, e-GP, part of E-Learning for Health, Dept. Of Health 2010-2011 http://www.e-lfh.org.uk/docs/projects/egp/List%20of%20live%20eGP%20sessions.pdf
Peer-reviewer, Journal of medical ethics, 2009 – present
Principal organiser/Co-chair: Joint conference between the Centre for Biomedicine and Society (KCL) and the Royal Society of Medicine (RSM) took place on Monday 1st February 2010 at the Royal Society of Medicine: "Is the principle of double effect still relevant in end of life care?"
Principal Organiser: RSM Myth and Reality Series, Evening meetings at the Royal Society of Medicine, which explore dilemmas taken for granted in current healthcare. 2004-2009 (for an example of one write-up:
Principal Organiser: RSM Medical Ethics Series: rolling programme of lectures and debates at London Medical Schools. 2000-2004
Papanikitas A, De Zulueta P, Spicer J, Knight R, Toon P and Misselbrook D, Ethics of the Ordinary, meeting run by the Royal Society of Medicine with The Royal College of General Practitioners, London Journal of Primary Care.2011; 4: 70-73http://www.londonjournalofprimarycare.org.uk/print/152.pdf
Papanikitas A and Prainsack B, Book review essay: James F. Drane: A Liberal Catholic Bioethics. Philosophia, 2011 (available online ahead of print) DOI: 10.1007/s11406-011-9319-4 http://www.springerlink.com/content/t363nl025q653213/
Papanikitas A and Toon P, Primary care ethics: a body of literature and a community of scholars? Journal of the Royal Society of Medicine.2011; 104:94–96 http://jrsm.rsmjournals.com/cgi/content/full/104/3/94
Papanikitas A and Toon P, Last but not least: The ethics of the ordinary, Br J Gen Pract, 2010; 60: 863-4 http://docserver.ingentaconnect.com/deliver/connect/rcgp/09601643/v60n580/s28.pdf?expires=1312974626&id=63919566&titleid=30000031&accname=King%27s+College+London&checksum=7BAF53EA5CEC2BF84D793B81101895FC
Bahal, N. Papanikitas, A. & Sokol, D. A bleeding controversy: duties and decisions in the face of conflicting advice, Intenational Journal Of Surgery. 2010; 8:32-34
Papanikitas A, Book review: The Art of Failure – The Anti Self-Help Guide by Neel Burton, J R Soc Med, 2010; 103: 503-504
Papanikitas, A. Splitting hairs over the definition of murder: Thomas Aquinas and the Doctrine of Double Effect. Clinical Ethics.2009;4: 211-212 http://ce.rsmjournals.com/cgi/content/abstract/4/4/211
Papanikitas, A. General Practice, Clinical Intention, and the Sexual Offences Act 2003. London Journal of Primary Care.2009; 2: 146-51 http://www.londonjournalofprimarycare.org.uk/articles/2128498.pdf
Papanikitas A and Papanikitas J. Acute ethics: risk assessment and and the doctrine of double effect in a referral to on-call urology, International Journal Of Surgery. 2009; 7(3):262-5
Papanikitas A, The Second-hand truth, Br J Gen Pract. 2009; 59:781
Papanikitas A. Doctors should do as they're told-myth or reality? Journal of the Royal Society of Medicine. 2009; 102(1):40-2 http://jrsm.rsmjournals.com/cgi/reprint/102/1/40
Papanikitas A, Viewpoint: Mum’s chances, Br J Gen Pract. 2009; 59:781 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2648925/?tool=pubmed
Papanikitas AN. Obstetrician vs. paediatrician: does inter-professional indifference compromise emergency caesarean safety? International Journal Of Surgery. 2008; 6(1):5-6
Papanikitas A. ‘We’. Journal of the Royal Society of Medicine. 2007; 100: 436-437 http://jrsm.rsmjournals.com/cgi/content/full/104/3/94
Agha RA. Papanikitas A. Baum M. Benjamin IS. The teaching of surgery in the undergraduate curriculum. Part II--Importance and recommendations for change, International Journal Of Surgery. 2005; 3(2):151-7
Agha RA. Papanikitas A. Baum M. Benjamin IS. The teaching of surgery in the undergraduate curriculum--reforms and results. [Journal Article] International Journal Of Surgery. 2005; 3(1):87-92
Agha RA. Papanikitas A. Baum M. Benjamin IS. The teaching of surgery in the undergraduate curriculum--reforms and results. [Editorial] International Journal Of Surgery. 2004; 2(2):74-6.
Poster Presentations (Selected):
Papanikitas, A., De Zulueta, P., Spicer, J., Knight, R., Toon, P. & Misselbrook, D. 2011. Ethics of the Ordinary – A meeting run by the Royal Society of Medicine with the Royal College of General Practitioners,Kings Interdisciplinary Discussion Society workshop, Everyday Ethics and Primary Healthcare, King’s College London, April 6th 2011
Papanikitas A, What is the role of medical ethics in primary healthcare for GPs? Themes from a qualitative PhD study, RSM/RCGP Conference: Ethics of the ordinary, London, Feb 15th 2011
Sritharan, Fang, Papanikitas, Lim and Davies, Doctors’ views on healthcare rationing within NHS reflect those of their patients, RSM/RCGP Conference: Ethics of the ordinary, London, Feb 15th 2011
Papanikitas and Sidhu,Primary Care Ethics – Gathering a literature for an optional module on an MSc in Primary Healthcare, Academy of medical educators conference, London, Jan 27th 2011
Papanikitas and Bahal, Intergenerational Learning and the use of Medical Alumni in Not-for-Profit Medical Education, Academy of medical educators conference, London, Jan 27th 2011
Making hard moral choices: how do UK General Practitioners reconcile ethical conflict? Centre for Biomedicine and Society launch, 18th June 2009.
Making hard moral choices: how do UK General Practitioners reconcile ethical conflict? 'Undertaking respectful Research' conference, Sussex Institute, 24th June 2009.
Get Through Clinical Finals: a toolkit for the OSCE (with Chan M and Bahal N), Royal Society of Medicine (RSM) Press, April 2006, ISBN 1-85315-615-9, £24.95 http://www.amazon.co.uk/Andrew-Papanikitas/e/B0034PRAZ6
Get Through The DCH Clinical (with Kennedy N and Goodliffe H), Royal Society of Medicine (RSM) Press, October 2008, ISBN 978-1-85315-764-6, £24.95
Crash course in Medical Ethics and Sociology(supervised by Carolyn Johnston and David Armstrong), under contract with Elsevier Publishing
5. Presentations (selected)
Intradepartmental Interdisciplinarity: a case study of shared learning in empirical political science and bioethics sampling strategies (Joint presentation with Ian Hill, Public Policy).KCL Social Science and Public Policy Summer Symposium, London June 17th 2011
Assisted Dying: Perspectives, Royal College of General Practice, Thames Valley Faculty Symposium, Wycombe, March 15th 2011 https://www.rcgp.org.uk/pdf/TV%20Microscope%2028.pdf
A sinking feeling: the encryption and decryption of bioethics in UK general practice, Wellcome Postgraduate Bioethics Conference, London, January 6th 2011
General Practice and Communication Skills Scenarios for OSCEs, 90-minute Interactive
presentation at RSM OSCE Training Day run by the RSM Clinical Section, October 19th 2007, 26th April 2008, 18th December 2008 and 15th of January 2009 at the Royal Society of Medicine.
“Examination of the hands –look!”, lecture to 3rd year Dental Students at King’s College London, Lecture Theatre 2, Guy’s Hospital, June 24th 2006
Justice and the trainee, a question of service versus education? –part of ‘Justice in medicine, Myth or Reality?’ meeting at the RSM on May 7th 2004
Joint meeting of the RSM Section of Surgery and the GKT Surgical Society: “This house would ban the teaching of surgery from the undergraduate curriculum.” October 23rd 2003
RSM Norah Shuster Prize meeting: ‘Worthy of mention: Why the first Human HIV Vaccine trial remains the most unreported’, February 6th 2001
6. Prizes & Grants
Wellcome Trust Bioethics Symposium Grant WT095377MF: Ethics of the Ordinary - A meeting run by the Royal Society of Medicine with the Royal College of General Practitioners, Feb 15th 2011
Institute of Medical Ethics Institutional award: Ethics of the Ordinary - A meeting run by the Royal Society of Medicine with the Royal College of General Practitioners, Feb 15th 2011
King’s College London Roberts Open Competition Grant (To support PG research):CBAS/RSM Conference - Is the principle of double effect still relevant in end of life care? Feb 1st 2010
GlaxoSmithKline RSM Fellowship (February 2007) awarded by The Royal Society of Medicine and The Wellcome Trust to “Trainees who demonstrate outstanding promise”
Norah Shuster Essay Prize (2001-2002), awarded by The Royal Society of Medicine and The Wellcome Trust for an essay or dissertation on a topic relating to the History of Medicine
7. Contact Details
Dr Andrew Papanikitas
Centre for Biomedicine & Society/ Department of Education and Professional Studies
Gerontology/Public Policy PhD offices
King’s Building (4th floor)
London, WC2R 2LS
(Please note this address may change, please contact by email if possible)