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The need for a medical ideology.

There is considerable irony in the paradox which confronts the profession today. After years of earnest, often bitter, debate, the medical community has finally perceived that rapidly rising demands for its services, as well as an explosive new technology, together make inevitable a fundamental transformation in the quality, scope, and nature of health-care delivery. It is precisely this perception, this awareness, which has led to a miscalculation of immense— possibly fatal—dimensions. For if the clamor for more and better medical care is the goal of technical advance, so is technology seen as the only agent of deliverance from the crisis imposed by rising expectations. What has emerged is a simple strategy: medical technology must be generated and deployed as quickly as possible. If only a sufficiently sophisticated technology can be developed, the prevailing ethic says, the medical needs of this profession's constituency can be satisfied. We submit that this ethic