Ethics as conversation: The crucible of family practice

Medical ethical thought, imbued with the idealism of traditional medicine, has always grappled with the problem of translating abstract principles into actions that do not violate the sensibilities of the patient or the physician. The problem of translation is minimal for the family physician engaged in routine conversations with patients and their family members. This “conversation” — staying with details, maintaining the union of values and facts, reflecting without detaching or distancing — suggests a model of ethical reasoning and problem-solving that warrants serious attention.