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Arch Surg. 1999;134:1175-1177.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

WE ARE a technology-driven profession. The use of technology in surgery since World War II has introduced revolutionary changes in surgical practice. Surgical intensive care monitoring, renal dialysis, open heart surgery, transplantation, computed tomography (CT), magnetic resonance imaging (MRI), the linear accelerator, pacemakers, serum channel autoanalyzers, diagnostic radioisotope studies, and minimally invasive surgery are examples of such progress. Technology is the totality of the means employed to provide objects necessary for human sustenance and comfort.¹

These advancements have become a mixed blessing. While enhancing the quality and duration of life, they have become a major part of today's health care costs. These technologies are consuming an increasingly large portion of our resources as manifested by the growth of Medicare, Medicaid, and private insurance carriers. But these advancements in technology have generated serious moral and social questions. The horns of our dilemma are this: should a nation have to choose between . . . [Full Text of this Article]