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Technology the dehumanizer.

Stanley Reiser's Medicine and the Reign of Technology argues that technological developments in medicine during the past three centuries have not only significantly changed the physicians' ability to diagnose disease, but in the process have also altered the relationships that previously existed between physicians and patients. Reiser further argues that after each move to a new technology or technique, skills using old techniques decline, with a sacrifice of the unique insights they once provided."Machines," he writes, "inexorably direct the attention of both doctor and patient to the measurable aspects of illness, but away from the human factors that are at least equally important" (p. 229). In sum, he contends that advancing medical technology is an overriding factor in the dehumanization of medical practice. This basic theme is elaborated by an examination of the development and impact of a number of medical instruments and techniques on diagnosis and medical practice, including, among others, the stethescope, microscope, thermometer, x-ray, electrocardiograph, and various chemical analytic techniques, as well as modern automated telecommunication systems and the computer. In addition, an analysis is made of the role of technology in the selection and evaluation of evidence in contemporary medical practice and ultimately in modern medical decision making. Reiser's work has a number of attractive features. It is written in an interesting and enjoyable manner. Furthermore, the bibliography he has gathered on nineteenthand twentieth-century medical technology cannot but benefit those who in future might wish to pursue this subject. Some sections, such as those discussing the impact of the telephone and computer on diagnosis, are informative and telling. Still, despite these very considerable virtues, the study disturbs, both by what is said and by what remains unsaid. Many of the instruments and techniques that Reiser analyzes have already been examined in other places. While it might be argued that it is useful to