Intended for healthcare professionals

Observations Ethics Man

How to think like an ethicist

BMJ 2010; 340 doi: (Published 23 June 2010) Cite this as: BMJ 2010;340:c3256
  1. Daniel K Sokol, honorary senior lecturer in medical ethics, Imperial College London
  1. daniel.sokol{at}

    A search for method in the madness of medical ethics

    Structure. That is the key. Structure. Did John steal the stethoscope? Go through each of the five components of theft: appropriation, of property, belonging to another, dishonestly, with the intention to permanently deprive. If a single element is missing, there is no theft. Was Tracy negligent when she failed to intubate the young child? Go through the elements of negligence: loss, duty of care, standard of care, breach, causation, and remoteness. Throughout the last year at law school we were told to “think like lawyers.” We had to lose the deep rooted instinct to judge the morality of a person’s act and replace it with a dispassionate legal dissection of the facts at hand.

    When training in medical ethics I was never told to “think like an ethicist.” There is no universally accepted way to do ethics, and at times the words from a Dilbert comic strip posted on the notice board of a bioethics department ring worryingly true. Having received the advice he wanted to hear, Dilbert muses that “90% of happiness is finding the right ethicist.” …

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