title: Fidelity to the healing relationship: a medical student's challenge to contemporary bioethics and prescription for medical practice.
abstract: As a medical  student, I observed that different physicians had strikingly different attitudes and approaches when caring for patients. The care of one patient in particular continues to challenge my understanding of illness and moral responsibility in the practice of medicine. In this paper, I illustrate the care of this patient in order to evaluate the dominant ethics I was taught in medical school, in theory and in practice, and argue neither principlism nor the ethics of care fully captures the moral responsibility of physicians. Emphasising fidelity to the healing relationship, a core principle derived from Pellegrino's virtue theory, I conclude that this approach to clinical ethics fully explains physician responsibility. Pellegrino deconstructs the practice of medicine to clarify the moral event within the clinical encounter and offers a sufficiently useful and justified approach to patient care.
authors.affiliation: Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA.
authors.forename: Blake C
authors.initials: BC
authors.lastname: Corcoran
authors.affiliation: University of Missouri, Center for Health Ethics, Columbia, Missouri, USA.
authors.forename: Lea
authors.initials: L
authors.lastname: Brandt
authors.affiliation: University of Missouri, Center for Health Ethics, Columbia, Missouri, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Fleming
authors.affiliation: University of Missouri, School of Medicine, Columbia, Missouri, USA.
authors.forename: Chris N
authors.initials: CN
authors.lastname: Gu
mesh_terms: D026686:Beneficence; D004645:Empathy; D028663:Ethical Theory; D004992:Ethics, Medical; D006801:Humans; D028681:Moral Obligations; D033262:Narration; D010348:Patient Care Team; D010686:Philosophy, Medical; D010817:Physician-Patient Relations / Q000941:ethics*; D028662:Principle-Based Ethics; D012935:Social Justice; D013337:Students, Medical / Q000523:psychology; D028722:Virtues
keywords: Clinical Ethics; Education for Health Care Professionals; Ethics; Ethics Committees/Consultation; Philosophy of Medicine