Current bioethics scholarship and pedagogy suffers from an insufficient correlation with the realities and variables of clinical medicine, particularly in its dominant paradigm of patient autonomy. Reference to various basic clinical factors will be made here toward proposing certain conceptual, tactical and pedagogical modifications to this paradigm. Keywords: clinical reality, informed consent, paternalism, patient autonomy, physician beneficence CiteULike Connotea Del.icio.us What's this?