Sens clinique, où va le soin ?

What is the status of care in contemporary clinical practice? What place does it occupy in clinical ethics, which is where such questions generally get raised? Clinical ethics, such as it is understood today, tends to be carried out by experts, namely (bio)ethicists who usually apply the classical principles of biomedical ethics to specific clinical contexts in order to solve moral dilemma in the realm of conflicting clinical decision making processes. Hence, when considered from the perspective of a philosophy of care, this type of expertise might tend to reduce the ethical dimension of care to issues of deontology; it therefore contributes to weakening the links that intimately bind together ethics and medical care. How, then, can we restore the ethical dimension of care that is at the heart of clinical practice, and make the question of ethical responsibility, which is inherent in every medical act, once more genuinely meaningful? The present article addresses this challenge by exploring various dimensions of care, and by sketching out how care might be articulated around the notion of practical wisdom. Such an approach allows us to pave the way for an ethic of responsibility for clinical medicine which considers ethics and medical practice as two sides of the same coin of care, and thereby attempts to restore full meaning to a concept that lies at the core of clinical practice.