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Bioethicists today are like Bolsheviks on the death of Lenin. They have, rather to their surprise, won the day. Their principle of autonomy is dogma. Their era of charismatic leadership is over. Their work of Weberian rationalization, of institutionalizing principle and party, has begun. The liturgy is reverently recited, but the vitality of Lenin's "What Is To Be Done?" has yielded to the vacuity of Stalin's "The Foundations of Leninism." Effort once lavished on expounding ideology is now devoted to establishing associations, organizing degree programs, installing bioethicist commissars in every hospital, and staffing IRB soviets. Not-so-secret police prowl the libraries hunting counter-revolutionaries and other wreckers; anxious academics denounce deviationist colleagues. A field once comprising diverse people from diverse backgrounds with diverse perspectives is increasingly populated by standard academics with standard academic opinions. Nevertheless, the samizdat literature persistently asserts that the policy of autonomy is betraying its promise. Explication of the autonomy principle is becoming repetitive and arid. Programs always need one more revision, one more Five Year Plan, before they can actually begin to work. Life in the vanguard of the (patient) proletariat grows irksome when the proletariat is so balky and ungrateful. Surely somewhere the next great bioethical idea is slouching toward Moscow to be born.