Ethical and Professional Implications The autonomy of a competent patient is an issue not often debated in medical ethics. Refusal of unwanted treatment is a fundamental right, compared to the common law of battery, available to all persons capable of competent choice. These fundamental rules of medical ethics entered an entirely new forum as medical technology developed highly effective life-sustaining treatments throughout the 20th century. Numerous watershed cases clarified these emerging issues in the 1960s and 1970s, none more effectively than that of Karen Ann Quinlan. Crucially, this case established that a once competent and recoverable patient could have his or her autonomy exercised by a surrogate regarding the refusal of life-sustaining treatment. This decision has had a profound effect on medical ethics, including the treatment of incapacitated patients in end-of-life situations, the creation of advance directives, physician-assisted suicide (PAS), and active euthanasia. The New Jersey Supreme Court allowed patient autonomy to be exercised by an incompetent patient. Although the legal implications of this decision vary from state to state, medical ethics must now incorporate the possible refusal of a once-competent patient incapable of expressing that refusal. This concept was not entirely unexpected by the medical community. By developing machinery capable of sustaining life even in the event of severe deficit, it is natural that medical ethics must adapt, growing to accommodate this new area of ​​consideration. Just as a competent person has the right to decide "how much to fight, how much to suffer, how much bodily invasion to tolerate, and... middle of paper... rightly protected, but patients and doctors must be much more willing to discuss difficult issues because of the opportunity for cases like Quinlan's to occur. Works Cited Cantor, Norman L.. “Twenty-Five Years After Quinlan: A Review of the Jurisprudence of Death and Dying.” Journal of Law, Medicine and Ethics 29 (2001): 1073-1105.Garrett, Thomas, Baillie, Harold and Garrett, Rosellen. Health ethics; Principles and problems. 4th edition. Upper Saddle River, New Jersey. Prentice Hall,2001.Meisel, Alan. “Quality of life and end-of-life decision making.” Quality of Life Research 12 (2003): 91-94. New Jersey Supreme Court. The Quinlan question. Washington: GPO, 1976. Sulmasy, Daniel. “The accuracy of substitute judgments in patients with terminal diagnoses.” Annals of internal medicine 128 (1998): 621-629.