INTRODUCTION

Ethical decision making is essential in the practice of medicine. The foundation of the provider–patient relationship rests on moral principles expressed in professional oaths that serve to protect and promote the interests and welfare of patients. Even the most mundane medical interactions usually involve weighing competing values and priorities to arrive at a management plan that is sound both from medical and moral vantage points. Health care providers, like most people, derive moral guidance from multiple sources including their personal upbringing and experiences, education, cultural traditions, and religious beliefs. Nevertheless, providers may not be adequately prepared to carry out their unique, professional ethical obligations and to facilitate resolutions of ethical dilemmas in a clinical setting. Knowledge of and skills pertaining to ethics in clinical practice and intraining have been shown to be highly variable and frequently deficient. Therefore, increasing efforts to educate health care providers in clinical ethics are important.

New ethical considerations in clinical practice will continually emerge along with advances in medical technology and life-sustaining therapies. Such advances have already raised fundamental ethical questions in areas pertaining to issues of life and death, and one's right to consent to, request, or refuse treatment, for example. Providers who care for geriatric patients may be more likely to confront ethical issues that concern end-of-life care and quality-of-life questions. The role of ethical analysis in medicine will become even more critical as the aging population expands along with increasing technological advances.