Document Type


Publication Date



For many years, the field of bioethics has been specially concerned with how the authority to make medical decisions should be allocated between doctor and patient. Today the patient's power-indeed, the patient's right-is widely acknowledged, at least in principle. But this development can hardly be the last word in our thinking about how medical decisions should be made. For one thing, sometimes patients cannot speak for themselves. For another, patients· make medical decisions in contexts that significantly include more participants than just the patient and doctor. Now, as this conference demonstrates, bioethics is beginning to ask what role the patient's family should play in making medical decisions. In addition, bioethics has in recent years increasingly been required to address another kind of problem: How should we resolve the ethical dilemmas associated with matters of reproduction- particularly novel means of reproduction, like in vitro fertilization and surrogate motherhood? As the technical capacities of medicine have expanded, these bioethical questions have raised pressing and puzzling issues about what a family is and how it should and should not be created. In short, bioethics today confronts ultimate and essential questions about the ethical and social bases of family life. My task here is to ask what bioethics might learn about these troubling questions from the experience of another field which has wrestled with them for centuries-family law. I have a second task as well. This is, after all, a symposium on family law, and I hope that I might make myself useful to that field by providing in brief form and with concrete illustrations a taxonomy and survey of some of family law's basic conceptual approaches.