Ethics are not optional in medicine: they are an essential and integral part for health care professionals. A common ethical code for everybody involved in health care, as proposed by Berwick et al,1 is potentially valuable and is to be welcomed, but the role and limitations of such a code need to be recognised.
Ethical codes can give shape and structure to our moral environment and summarise our ethical position while leaving ethical responsibility with the individual practitioner. Looked at in this way, individual variation and personal issues can be taken into account. An ethical code can facilitate the discussion of ethical issues in difficult cases, and distinctive ethical positions can be established and argued, leading to broader and more secure moral conclusions. An ethical code can describe the ethical attitudes that are shared by healthcare workers, and in this it can be immensely valuable and influential. But what it cannot do is provide the certain answers for the many ethical problems encountered in the course of medical practice.