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Teaching in general practice: considering conceptual lenses

matters at the expense of ethical issues. Ironically, this choice can be appreciated as an ethical issue in itself, not unlike the ethical issue that arose when the medical student reported by Elit et al. devalued her own bearing of witness to her patient. By refraining from making an explicit articulation of ethical issues, such preceptors deprive patients of a full expression of their autonomy and convey to the resident that ethical concerns are secondary to pathophysiology and expediency. Yet these situations could have become profound teaching moments, had the attending doctor explicitly invited the resident to reflect on quandaries such as why critical ethical dimensions of patient care are often shortchanged.