This wide-ranging collection of essays by one of the foremost medical ethicists in the United States explores the claim that justification in ethics, whether of matters of theory or practice, involves achieving coherence or reflective equilibrium (as Rawls has called it) between our moral and nonmoral beliefs. Among the practical issues addressed in the volume are the design of health care institutions, the distribution of goods between the old and the young, and fairness in hiring and firing.