The format of the chapters is unchanged since the first edition. Each follows the same sequence: case examples, legal issues, clinical issues, pitfalls, case example epilogues, action guide, and selected readings. The wise reader will resist the temptation to jump from the intriguing vignettes that start the chapters to the epilogues that present the resolution without first going through the intermediate considerations, which are the substance of the handbook. I found it particularly useful that the suggested readings are easy to find immediately following the clinical material to which they refer. These references are current, many of them new since the last edition. For instance, in the chapter on competence and substitute decision making, the earliest reading cited was written in 1989. The law does move in its own way to deal with changing reality, in this instance an aging population.