ABSTRACT
The major forces which have led to change have been science and technology nurtured by economic development in a free, or at least a relatively free, enterprise system. Science and technology have enhanced economic development. The advances in the science and technology of medicine changed not only the ecology of disease but the entire matrix of medicine as well, including everything from the relationship between hospitals and doctors to the willingness of government to pay for the fruits of medical invention. The remarkable success of medical science has conferred on it a magical quality that is seductive for those who practice the art, but that is dangerous as well, for the expectations of patients are often too high and the denial of risk too great. Medicine is not only scientific and even effective, but it is also respectable. Even the association of AIDS with homosexuality and drug addiction does not inhibit public discussion.
