You can’t fully understand what someone else needs as a human being, and all the more so as a patient, without recognizing two things: their essential commonality with you – you are both human beings – and their uniqueness. Each person has particular wishes. Thus, only through a relationship based on trust, in which each party feels safe enough to divulge those wishes, and a relationship based on open communication, in which those wishes are actually stated, can ethical practice, medical or otherwise, be achieved.
The relationship, however, is reciprocal. Ethics is not reducible to communication, nor vice versa. Some have even suggested that relationship difficulties in the doctor-patient relationship are best dealt with through expanded use of the specialty bioethics consult service. I argue against this notion in a recent article, which you can read here. Communication is something which every provider should work towards achieving, and though bioethics has much to offer medicine, a specialty consult can do more harm than good to the patient-doctor relationship – especially one beset by difficulties.