Intended for healthcare professionals

Observations Ethics Man

The moment of truth

BMJ 2010; 340 doi: (Published 14 April 2010) Cite this as: BMJ 2010;340:c1992
  1. Daniel K Sokol, honorary senior lecturer in medical ethics, Imperial College London
  1. daniel.sokol{at}

    How can doctors foster the virtues that will help them cope with those “this is it” moments in the practice of medicine

    Edmund Pellegrino, a professor of medicine and a giant of medical ethics, once remarked that, for the clinician, the “moment of truth may come at three in the morning, when no one is watching.” This prompted me to ponder on “the moment of truth.” What is it? And can we prepare for it?

    The moment of truth is a bullfighting term. The “hora de verdad” refers to the moment when the matador entices the bull with the “muleta” (the red cape draped over a stick) and, with the precision of the anaesthetist hitting the epidural space in an obese patient, plunges the sword into the bull’s neck for the kill. If he thrusts the sword at a slight angle he will sever the aorta and the bull will die in seconds. If the matador misses, his body is exposed to the sharp horns of the frenzied animal.

    We encounter a moment of truth when we are put to the test, and how we respond becomes a …

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