Ethical reasoning is a clinical competency that can be taught and practiced with medical learners at the bedside. It is not unlike clinical reasoning in its systematicity. It involves identifying an initial concern, gathering information, assessing the ethical issue, engaging in discussion, and, finally, deciding what should be done. However, teaching ethics in the course of patient care is more than competent reasoning. It also involves supporting learners to form professional identities by heightening their ethical sensitivity and role modeling ethical reasoning. Ethical reasoning is an instance of good clinical practice, and the competency should be informed and motivated by a self-aware, professional identity.