Intended for healthcare professionals

Observations Ethics Man

Embracing the ethically complicated patient

BMJ 2016; 354 doi: (Published 05 July 2016) Cite this as: BMJ 2016;354:i3727
  1. Daniel Sokol, barrister and medical ethicist
  1. 12 King’s Bench Walk, London, UK
  1. Sokol{at}

Ethical challenges provide opportunities to improve patient care

All clinicians are familiar with the medically complicated patient. Those patients have, for example, overlapping illnesses, complex manifestations of symptoms, or uncommon reactions to treatment. They fill the pages of medical journals as case reports. They are the subject of grand rounds and departmental meetings.

Less celebrated is the ethically complicated patient. These are patient whose circumstances raise perplexing ethical questions for the healthcare team, and the care of such patients was the theme of this year’s International Conference on Clinical Ethics Consultation, in Washington, DC.

Conflicting values

The conference was an ethicist’s dream but less so for a clinician, with case after case of conflicting values; tensions between patients, relatives, and medical teams; offensive, abusive, and …

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