With this edition of Biomedical Ethics Reviews we commence a somewhat new focus for the series. Building on its solid tradition of exploring and debating pressing bioethical issues of the day, this series will now also examine the real-life implications of these issues for patients and the health care system in which care is delivered. With each topic, attention will be focused not only on the theoretical and policy aspects of ethical dilemmas, but also on the clinical dimensions of these challenges, and effects on the patient–physician relationship