Achieving one's natural life span requires the elimination of hereditary imperfections and injurious environmental influences. A quality of living that defines one's distinctive and unique character, however, requires more than mere survival. In adulthood, one must ascend and acquire the elements of three tiers of quality living. The first, or egoistic, tier is composed of happiness, well-being, independence, and security. The second, also egoistic, includes the drive for success, the accumulation of wealth, and the acquisition of power. The third, or altruistic, tier, and the summit of the three, consists of the ethical principles of honesty, non-maleficence, beneficence in following the Golden Rule, and the responsibility to respect the rights of everyone; all leading to one's compatible existence in society.
The combination of achieving the natural life span and the ascent of the three tiers of quality living may then be envisioned as the semicircle of life.
Seven major medical subjects with ethical issues adversely affecting the quality of living are addressed: the doctor-patient relationship, diet and nutrition, medication, advances in biotechnology, medical research, decision-making regarding late-life care, and health care reform.
