Background <p>The increasing demand for access to general practice data for research and policy development presents ethical challenges for Australian general practitioners (GPs), particularly around patient consent, privacy, and trust. As frontline custodians of patient information, GPs must navigate the tension between supporting public benefit and upholding their professional obligations to confidentiality and autonomy.</p> Methods <p>This qualitative study involved interviews with 19 Australian GPs who reported limited experience with secondary use of general practice data. Participants were recruited via professional networks and interviewed using open-ended questions informed by prior community jury recommendations. Thematic analysis was conducted using NVivo 12, with an ethical lens applied to identify key themes related to trust, consent, and data governance.</p> Results <p>GPs expressed broad support for using general practice data in research but emphasised the centrality of trust in the doctor–patient relationship. Most participants preferred an opt-in consent model, citing transparency and respect for patient autonomy. Concerns were raised about privacy breaches, re-identification risks, and the ethical implications of remuneration. Organisational constraints, such as time pressures and limited decision-making authority within practices, were identified as barriers to implementing ethical data-sharing practices.</p> Conclusion <p>Australian GPs are pivotal in shaping ethical and effective models for data sharing in general practice. However, substantial policy, educational, and ethical work is needed to address their concerns. Building trust, ensuring transparency, and respecting patient autonomy are essential to securing GP support for routine data collection. A collaborative approach involving government, community, and general practice stakeholders is necessary to develop acceptable and sustainable data-sharing frameworks.</p>