The situation around Terri Schiavo was a deeply held conflict over what to do if someone isn't going to return to consciousness or competence. Who will decide? Even there, where we had settled legal rules, we still had disagreement. We're torn about these things.

Anyone who lives in Washington and has an official position viscerally understands the cost of a lack of privacy. Every dinner - especially ones with a journalist in attendance - is preceded by the mandatory, 'This is off the record.' But everyone also knows, nothing is really 'off the record.

Physician-assisted suicide and euthanasia have been profound ethical issues confronting doctors since the birth of Western medicine, more than 2,000 years ago.

Patients who are being kept alive by technology and want to end their lives already have a recognized constitutional right to stop any and all medical interventions, from respirators to antibiotics. They do not need physician-assisted suicide or euthanasia.

Over his illustrious career, John Harris has explored the most challenging bioethical questions with insight, engaging wit, and eloquence. In Enhancing Evolution, Harris does it again. He argues that it is not just an option but an obligation for people to use available biomedical technologies to enhance their own--and their children's--physical and mental abilities. Harris rightly deserves his reputation for fearlessly following his ethical arguments wherever they lead.

Reasoning based on cost has been strenuously resisted; it violated the Hippocratic Oath, was associated with rationing, and derided as putting a price on life... Indeed, many physicians were willing to lie to get patients what they needed from insurance companies that were trying to hold down costs.

An obvious example is not guaranteeing health services to patients with dementia.