Lifestyle, health and the ethics of good living. Health behaviour counselling in general practice.
OBJECTIVE
To present theory that illustrates the relevance of ethics for lifestyle counselling in patient-centred general practice, and to illustrate the theory by a qualitative study exploring how doctors may obstruct or enhance the possibilities for ethical dialogue.


METHODS
The theoretical part is based on theory of common morality and Habermas' communication theory. The empirical study consists of 12 consultations concerning lifestyle changes, followed by interviews of doctors and patients.


METHODS
Identification of two contrasting consultations holding much and little ethical dialogue, "translation" into speech acts, and interpretation of speech acts and interviews guided by theory.


RESULTS
General advice obstructed possibilities for ethical clarification and patient-centredness. Ethical clarification was asked for, and was enhanced by the doctor using communication techniques such as interpretation, summarization, and exploration of the objective, subjective and social dimensions of the patients' lifeworlds. However, to produce concrete good decisions an additional reflection over possibilities and obstacles in the patient's lifeworld is necessary.


CONCLUSIONS
Consultations concerning lifestyle changes hold opportunities for ethical clarification and reflection which may create decisions rooted in the patient's everyday life.


CONCLUSIONS
The study suggests that GPs should encourage active reflection and deliberation on values and norms in consultations concerning lifestyle changes.
Walseth
Liv Tveit
LT
Research Unit for General Practice, Uni Health, Bergen, Norway. liv@walseth.no
Abildsnes
Eirik
E
Schei
Edvin
E
D000328:Adult; D003142:Communication; D037001:Directive Counseling / Q000941:ethics* / Q000379:methods; D004992:Ethics, Medical; D005260:Female; D058005:General Practitioners / Q000941:ethics*; D015438:Health Behavior; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D007406:Interview, Psychological; D008019:Life Style; D008297:Male; D009042:Motivation; D010353:Patient Education as Topic / Q000941:ethics; D018802:Patient-Centered Care / Q000941:ethics*; D010817:Physician-Patient Relations; D036301:Qualitative Research