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The process of making medical decisions in the United States today is, in theory, a neat and well-defined affair. Authority and responsibility are shared, as mentally and emotionally capable adults choose voluntarily and intelligently from among various options whose relative risks and benefits their personal physicians have fully explained to them. Gone are the days of medical paternalism, when arrogant health care professionals misused their power to force particular treatments on dependent patients who blindly trusted them. In place of that trust and good riddance bioethicists and health care lawyers have, over the past three decades, substituted the
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