To the Editor. —In the recent editorial in theArchives 1 and in several other publications, 2,3 Sider and Clements have criticized the contemporary field of medical ethics or bioethics in terms that most of us who are involved in that enterprise on a day-to-day basis find unrecognizable and irrelevant. The flaws in these authors' condemnation of philosophical ethical theory as necessarily formalistic and empty, and their proposed alternative ethical theory based on systems concepts and biological norms, require criticism of a much more extended scope than can be encompassed in a letter to the editor. I wish merely to indicate that their portrayal of contemporary bioethics omits mention of active debates which address the very issues that they feel have been excluded. 1 The centrality of the concept of autonomy in contemporary bioethics cannot be doubted. However, the way in which autonomy must be balanced against other ethical principles,