As science and medicine transform the realm of the possible, ethical choices grow ever more complex. We are compelled to consider how to use fetal genetic testing; whether to pay people to become organ donors; how to design clinical trials in low-resource countries; how best to protect the autonomy of an aging population; and the role of the physician in assisted suicide. Resource limitations, religious beliefs, political structures, gender roles, and cultural norms all shape the debates. What’s the process for resolving tough ethical dilemmas? Are there “right” answers and who decides what they are?