Abstract: The FME symposium on teaching medical ethics takes up the issue of competence and responsibility in matters concerning bioethics (1). Foreseeably, the medical participants argue that physicians are prepared, or can be easily prepared, to handle all relevant aspects of medical ethics. The contrary position is sustained by the philosophically trained participants, who believe that physicians do not, in fact cannot, sufficiently manage medico-ethical problems. This paper sees a role for both parties. Medical ethicists should properly be involved in medical education and in analytical and systematic study of medical ethics. They should not generally be involved in clinical medico-moral decision-making, which is properly the realm of patient and (ethically competent) doctor.Participants in a symposium on teaching medical ethics published in the September 1982 Journal of Medical Ethics disagreed on whether physicians are prepared or can learn to incorporate ethical considerations into clinical decision making, and on what role bioethicists should play in the clinical setting. Kottow criticizes the positions of several participants, concentrating on the conservative stance of J.D. Swales, and proposes a two-tiered decisional system. At the clinical level decisions would be made by physicians and patients, working as members of ethically informed medical teams, while bioethicists would contribute at a more analytical level as advisors, evaluators, and educators.