Few deny the impact on physicians, patients, and patients' families of US Supreme Court decisions. Actions the Court takes, or refuses to take, carry implications for how patients receive care, the type of care they receive, how medical care will be paid for, the extent to which patients can trust their doctors, and even how patients die. Below the surface of constitutional interpretation and judicial temperament lie ethical commitments and value considerations. Justices do not decide cases, especially biomedical ethics cases, in a vacuum. Because the rulings of the Court are of such importance for medical ethics, students and health professionals must search for and evaluate theories, principles, and concepts the Justices may be using. Not only does such a search and evaluation facilitate understanding of any particular ruling of the Court, it also provides clarity and relevance to the concerns of medical ethics. Too much is at stake for those involved in health care—receiving services, providing care, or studying its moral constraints—to ignore the explicit and implicit ethical considerations of the Justices.