How should democratic governments make policy on ethically contentious health issues? In different countries, and among jurisdictions within countries, different answers have been generated to the same policy questions in medicine and public health: some of these answers are codified in actual law and others emerge as more informal practices. Many policy questions result in divergent or even conflicting responses across jurisdictions that are proximate to one another. Even countries that share many historical and institutional characteristics—such as Australia and Canada, our foci in this book—can come to similar or different policy responses, depending on a range of factors within the local context. In addition, the policy mechanisms for addressing contested bioethical questions, and more generally for the governance of controversial ethical issues, vary considerably, as do the processes for involving the public in policymaking.