Training in clinical ethics, a necessary tool for professional excellence of the internist

Internists must respond to increasingly complex clinical scenarios in a context of progressively increasing life expectancy, techno-scientific development and accelerated demographic and sociocultural changes. Ethical reflection is a useful tool to resolve and prevent value conflicts, which are frequent in clinical practice. The ethical training of internists contributes to professional excellence and can be oriented at two complementary levels: 1) development of skills in all internists for the management of "clinical microethics", which allow the integration of the techno-scientific aspects of medicine in a satisfactory clinical relationship at a human level; 2) specialization for internists who are experts in bioethics, to lead ethics committees (and other consulting models) in a more local setting and participate in bioethical debates and the development of normative ethics in a more general setting.