Back to the Beginning
In these pages, I've tried to share my journey between clinic and classroom. At first glance, thinking with cases seemed self-evident. But it didn't turn out that way. I was led backward to the story and forward to the practice community. Together, these opened up issues of personal and professional moral values. They pointed me to the not so hidden assumptions and attitudes that guide us through the clinical encounter. They exposed the existential side of things -- suffering, denial, depression-that shapes that encounter. At the same time, they pointed to the new agenda of medicine and biomedical ethics. Thus the rapid diffusion of science and technology, and the rise of market rationalization to resolve issues that were ignored when third-party payers made costs invisible.
While exploring the ethical side of clinical experience, I have tried to keep on eye on the possibilities it might have for moral education. Of course, a direct transfer from the clinical encounter to the classroom makes no sense. The teacher is not confronted with the urgency of cure, although it is not far-fetched to understand teaching as the "cure of souls." Nor is the teacher equipped -- or likely to be equipped -- with the armory of tools, skills, resources, and traditions that make the practice community effective. Teaching does not enjoy the support of a well rooted practice community, although its traditions reach back to the