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Solo doctors and ethical isolation
  1. R J Cooper
  1. Correspondence to Dr R J Cooper, School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK; Richard.cooper{at}


This paper uses the case of solo doctors to explore whether working in relative isolation from one’s peers may be detrimental to ethical decision-making. Drawing upon the relevance of communication and interaction for ethical decision-making in the ethical theories of Habermas, Mead and Gadamer, it is argued that doctors benefit from ethical discussion with their peers and that solo practice may make this more difficult. The paper identifies a paucity of empirical research related to solo practice and ethics but draws upon more general medical ethics research and a study that identified ethical isolation among community pharmacists to support the theoretical claims made. The paper concludes by using the literary analogy of Soderberg’s Doctor Glas to illustrate the issues raised and how ethical decision-making in relative isolation may be problematical.

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • i The example of Soderberg’s Doctor Glas was chosen particularly for its relevance because the central character is a family doctor working alone and thus represented a more fitting literary example than, say, Hesse’s lonely eponymous character Steppenwolf or the moral agonising of Dostoyevsky’s Raskolnikov in Crime and Punishment.

  • ii This may be contrasted with the actions of another fictional doctor working alone—that of Dr Wilbur Larch in John Irving’s The Cider House Rules.

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