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It is sometimes useful to remind oneself of the rapidity with which social change now occurs. Thirty years ago, at the beginning of the modern era of bioethics, the central issue was whether patients had the freedom to refuse the life-sustaining treatments that many health care professionals felt compelled to provide, even when the treatment seemed purposeless to patients. Although patients are unfortunately still cajoled into accepting unwanted treatment in quite a few quarters today, in many other clinical settings the pendulum has now swung the other way. Increasingly, patients and families seem to be demanding life-sustaining treatment that health
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