The picture I have drawn corresponds neither to an image of unbridled professional discretion nor to one of patients’ rights triumphant. As many observers of contemporary medicine have argued, the discretion of physicians in clinical decisions (like the discretion of professionals in other fields) depends on their ability to make successful claims to the exclusive command of technical knowledge. Yet, while . . . physicians . . . make such claims, they don’t always succeed either in convincing themselves that they are legitimate or in converting them to influence over patients and their families, for the claims of physicians are met by the counterclaims of patients and, more important, families. . . . The institutionalization of patients’ rights, in law and in hospital policy . . . empower[s] families when they do insist on doing everything. In such a situation, physicians may continue to exercise considerable influence and enjoy considerable discretion. By no means have they been reduced to the role of technicians and nothing more. But at the same time, they must, at the very least, take the wishes of patients and families into account.