Views & Reviews Personal view

Ethicist on the ward round

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39344.636076.59 (Published 27 September 2007) Cite this as: BMJ 2007;335:670
  1. Daniel K Sokol, lecturer in medical ethics and law, St George's, University of London
  1. daniel.sokol{at}talk21.com

    Not so long ago in the BMJ I quipped that most professional medical ethicists could not distinguish their “gluteus maximus from their lateral epicondyle” and suggested that such ethicists should undergo a short clinical attachment (BMJ 2006, 333:1226 doi: 10.1136/bmj.39055.658762.59).

    Soon after publication, a nephrologist kindly invited me to observe a ward round at his hospital. It proved to be a puzzling experience, not because the blood gases, creatinine levels, diagnostic tests, and myriad statistics recited by a junior doctor sounded like one of Mallarmé's incomprehensible poems, but because, as the afternoon progressed, I noticed the patient-as-person fading behind this shroud of science. I felt comfortable with my consultant, my team with their dangling stethoscopes, the all-knowing computer wheeled by the bedside, and the timid patient, dwarfed by our confident crowd. Ethics seemed a million miles away.

    This absence of ethics was most puzzling of all. I spend my days thinking, teaching, and writing about medical ethics, but there, in a group of doctors and with the patient before me, …

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