  This characterization of the ends of medicine allows Pellegrino to limit severely what counts as a medical benefit for patients: Benefit in medicine is limited to healing and related activities such as caring for and preventing injury or disease. This thesis is controversial. Even if healing and the like are interpreted broadly, medicine does not seem to many in bioethics to have such precise boundaries. If beneficence is a general moral principle and if physicians are positioned to supply many forms of benefit, there is no manifest reason why physicians’ hands are tied to the single benefit of healing, even in their role as medical professionals. The range of benefits that might be considered relevant seems broader and could include prescribing pharmaceutical products or devices that prevent fertility (where there is no healing-related purpose), providing cosmetic surgery for strictly aesthetic (by contrast to reconstructive) reasons, helping patients write realistic living wills, complying with terminally ill patients’ requests for physician-assistance in dying by hastening death, and the like. If these are bona fide medical benefits, how far does the range of benefits extend? If a physician runs a company that manufactures powered wheel chairs for the elderly, does this activity supply a medical benefit? When physicians consult with an insurance company about cost-effective treatments that save their patients money, is this activity a beneficent component of the practice of medicine?