The interface between ethics and clinical practice: principles, procedures and personalities

Having to say 'no' to patients who are seeking fertility treatment can be difficult. Creating new financial or statutory barriers may not resolve the ethical problems. Ad hoc legislation may not be able to cope with scientific advances, commercial pressures and sympathetic exceptional cases. Political and clinical decisions often are made on the grounds of moral pragmatism, 'satisfying as many demands as we can' and seeing 'what works'. The best way to make pragmatism work for the common good is through education, establishing procedures that promote informed public and professional reflection on the issues and ways of educating health professionals which value and encourage the growth of practical wisdom that is rooted in self-knowledge and imaginative sympathy.