The report of the US Surgeon-General for 1980 begins with the auspicious statement that the American people have never been healthier (1). As prime evidence, the report cites the fact that life expectancy for both sexes is now in the mid-seventies. Four diseases that at the tum of the century were major killers-diphtheria, tuberculosis, gastroenteritis, and poliomyelitis­ have been brought under control. Last year, the combined death toll from those four diseases was 10,000 . If the incidence in 1900 had continued in a straight line, the death toll in 1978 would have been 875,000. Even some forms of cancer are now on the decrease, cancer of the stomach for example. The rising curve in heart disease has flattened out and is being reversed. This improvement in the nation's health is attributable to many factors, not least among them the continuing development of advanced medical technology. Within little more than two decades, new techniques have been devised both to diagnose otherwise elusive cases and to treat cases of ex­ traordinary complexity. The usefulness of transistors in detecting subtle changes in internal chemistry, or to regulate heartbeat; the efficiency of laser beams in intricate surgery, without the hazards of blood loss; the help furnished by computers in dealing with shock; the remarkable contributions made by science and technology to organ transplants; the prodigious for­ ward leap represented by computerized tomography; the availability not just of radioactive tracers but of sound and echoes to provide basic informa­ tion; cardiopulmonary bypass machines; high-voltage radiation; kidney di­ alysis devices; blood gas analyses-all these are only a few examples of the rapidly enlarging role of machines and chemistry in the war against disease. But inevitable questions arise. What effect does advanced medical tech­ nology have on the physician-patient relationship? Indeed, how do the new