Concerns about research ethics were further increased by a research project called the Tuskegee Study, sponsored by the United States Public Health Service to assess the clinical course of syphilis. It began in 1932 and was ended at the direction of the Congress of the United States in 1972. Public health researchers conducting the study withheld both diagnostic information and effective treatment from black men enrolled in the study in order to keep their ongoing participation. The abuses of the Tuskegee Study prompted the formulation of a national commission to examine ethical issues in research, and eventually led Congress to establish regulations requiring informed consent from participants and the review of all federally funded health research by appointed review boards. .
Life-support became more advanced and affluent in the 1960s, and many problems arose, with the growth of medical ethics as its own distinct field. For centuries, death was clearly defined by no pulse and no breathing. Now with the new technologies in life support, there was a blurred line of what death's signs were. Medical ethicists struggled to define death in a new way, so that the gravely ill would have the right to live maintained by technology, while those who had technically died would not be maintained on life-support machines. In the United States, many states have adopted legislation formally recognizing brain death "the loss of brain function, which controls respiration and heartbeat "as certification of death. Most European nations, Canada, Australia, and Central and South American nations define death either as the loss of all independent lung and heart function or the permanent and irreversible loss of all brain function. .
One notorious case involving the right to end one's life due to brain death (being in a vegetable state) occurred in 1989. A father, Rudy Linares, held medics at bay with a gun as he disconnected his brain-damaged son from a respirator after having been told via answering machine that the hospital had concluded it was forbidden under Illinois law from "pulling the plug.
