A return to virtue.

T he dominant trend in contemporary medical ethics describes ethical behavior in terms of the principles and rules that must be followed to bring it about, most notably nonmaleficence, beneficence, justice, and respect for autonomy. An alternative approach to ethics, virtue ethics, emphasizes not principles and rules, but rather the virtues, or characteristics, whose exercise will bring about ethical behavior in a person. In 1996, Academic Emergency Medicine published ‘‘Virtue in Emergency Medicine,’’ a project of the Society for Academic Emergency Medicine Ethics Committee. This article sought to supplement principle-based ethics of emergency medicine (EM) with a virtue-based analysis of what is essential to being a good emergency physician (EP). Good not merely in the sense of technical competence, but in the sense of achieving overall excellence in one’s role. The paper was written in a timeless way, as the virtues it discusses—prudence, courage, temperance, justice, unconditional positive regard, charity, compassion, trustworthiness, vigilance, agility—represent attributes any EP must have to carry out his or her practice in the best manner. However, even timeless virtues need frequent reappraisal and reinforcement. Therefore, because of its unique value in delineating the core of good ethical practice in our field, Academic Emergency Medicine is reprinting this seminal paper in this issue, to return it to the center of the discourse in our specialty. To begin the conversation, in this commentary we reflect on the particular relevance the paper has displayed in the decade or so since it was first published. Twelve years may seem a bit soon for such a reappraisal, especially when discussing timeless virtues, many of which have been recognized since ancient Greece. However, the past decade has wrought tremendous changes, political, social, and economic, in all aspects of life, including EM. The virtues discussed in the article provide valuable tools for appropriately dealing with many of the unprecedented challenges that have arisen, or been greatly magnified, over the past decade. Understanding how this is so can help us appreciate and utilize the lessons of the article going forward.