Ethical aspects of clinical practice.

HYPOTHESIS: Clinical ethics is grounded in the belief that medicine is an inherently moral enterprise. Sick persons ask physicians to help them get better and physicians profess to be morally committed and technically competent to help the sick. DATA SOURCES: MEDLINE literature search and review of published works on medical ethics, and the references cited therein. STUDY SELECTION: Critical studies containing supporting evidence were selected. DATA SYNTHESIS: The central ethical aspects of modern medical practice are clinical competence, respect for patients and their health care decisions, and maintaining the primacy of patient's need in the face of external pressure in a changing social, economic, and political climate. There is a need to teach both the cognitive and behavioral aspects of ethics. Development of these skills, in turn, depends on the character of the physician who will be applying these skills.
CONCLUSIONS: The outcome of patient care can be improved by efforts made to secure informed consent of the patient. This also helps avoid ethical conflicts, confusion, and misunderstanding between patients and physicians. Clinical ethics should be an integral part of medical education at all levels in medical school, in the residency, and in continuing education.