Identification, analysis, and resolution of outpatient ethical problems require the physician’s explicit consideration of th epersonal, social, financial, psychological, and emotional aspects of care, and the use of clinical judgment. Clinicians can separate the patient’s interests and desires from the interests and desires of others and can recognize conflicts that arise from dual loyalties in particular clinical situations. Physicians’ communications and negotiations with outpatients can enhance both patient autonomy and physician autonomy. Primary care physicians can practice preventive ethics by helping their patients outline their goals for future medical care. Finally, as citizens informed on matters of health, physicians have professional and social responsibilities to educate the public and promote the common good.