[The physician facing the evolution of ethical concepts in our times]

Medical ethics institutionalized with clinical activities being determined by the patient's interests as they developed in the doctor-patient relationship. The ethical nature of the health concept was emphasized in the positive definitions of health such as the one by the W.H.O.. The established goals for clinical intervention surpass the effective medical capabilities. The curricula of medical schools will have to be reviewed in light of these goals. We characterized the contemporary values and the way medicine has adapted to them: superspecialization and doctors' change in social image brought about by the impact of technocracy in clinical activities, increasing costs of medical care, the interference of non medical managers in the process of clinical decision, litigation and breaches of confidentiality. Technical and social developments lead to new ethical problems in which the moral principles of the doctor can be confronted with patients' demands in situations of difficult choice. Contraception, abortion, genetic engineering, transplants, allocation of scarce resources, the expansion of drug dependency and euthanasia are examples of problems that clinicians frequently face today.