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The development, application, and use of technological advances, especially instruments and machines, to diagnose and treat disease, sustain life, substitute for organs or organ functions, and facilitate rehabilitation have escalated enormously in recent years. This escalation has occurred not only because of growth of technological knowledge, but also because of the increased willingness of third-party payers to foot the bills, which in turn is the stimulus required to encourage industry to view many kinds of technological advances as sources of revenue and profit. In general, however, there have not been corresponding advances in the evaluation of some of the technological advances (such as adequate epidemiologic investigations) or in the anticipation, evaluation, and solution of the social, ethical, and even legal problems resulting from the applications of the advances. Even casual reading of the daily press makes evident the enormity of some of the problems and the inability to cope with
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