Physicians are at the center of the health care process. In this central role, they use their knowledge, skills, and defined processes to provide or coordinate health care for patients. The success of the patient-physician relationship is determined by the way this relationship is valued, developed, nurtured, and maintained. Changes in the health care process bring changes in stakeholders, relationships, structures, and values. Physicians must not only address traditional bioethical issues, but also business ethical issues. Furthermore, health care is no longer a local issue, but spans regions, states, even countries. The ethical values of many can affect any single health care decision. The physician’s central position forces direct involvement with many ethical issues. Physicians thus witness and participate in decision-making that has important ethical implications. Because their position is central and influential, others may attempt to gain their support. Physicians must be familiar with ethical principles, recognize situations that involve ethical decision-making, have the ability to analyze the ethical dilemma, and select a solution from among several correct solutions.

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