A competent physician is not only characterised by scientific knowledge and technological skill. In order to be recognised as a comprehensive expert of health care and despite an increasing tendency to specialisation he or she has more and more tasks in clinical counselling because the patients must give their informed consent before a treatment can be started. This shift from paternalism to the work with competent patients is one of the main reasons for the importance of ethics in high-tech medicine where physicians often have to cooperate with experts of psychology and psychotherapy.