There is the world of ideas and the world of practice; the French are
often for sup- pressing the one and the English the other; but neither
is to be suppressed. -Matthew Arnold The Function of Criticism at the
Present Time From its inception, bioethics has confronted the need to
reconcile theory and practice. At first the confrontation was purely
intellectual, as writers on ethical theory (within phi- losophy,
theology, or other humanistic disciplines) turned their attention to
topics from the world of medical practice. Recently the confrontation
has grown more intense. The ap- pointment of clinical ethicists in
hospitals and other health- care settings is an accelerating trend in
North America. Concomitantly, those institutions involved in training
peo- ple in clinical ethics have added organized exposure to the world
of practice, in the form of placement requirements, to the normal
academic course load. In common with other dis- ciplines, bioethics has
begun to see clinical training as a con- dition of didactic theory and
apprenticeship.