  Controversy over the ends of medicine requires decisions about what is to count as the practice of medicine and, derivatively, what counts as medical beneficence. Controversy appears not only in the literature of biomedical ethics, but also in some split decisions of the U. S. Supreme Court—notably in Gonzales v. Oregon, a case dealing with physician-hastened death. The majority decision in this case asserts that there is no consensus among health care professionals about the precise boundaries of the legitimate practice of medicine, a legal notion similar to the medical-ethics notion of the proper ends of medicine. The court notes that there is reasonable disagreement in the community of physicians regarding the appropriate process for determining the boundaries of medical practice and that there is also reasonable disagreement about the extent to which the government should be involved in drawing boundaries when physicians themselves disagree. This court opinion allows that, depending on state law, a physician may legitimately assist in various ways to help bring about the death of a terminally ill patient who has explicitly and competently requested this assistance from the physician.