Medical Technology

To the Editor.—  I have read and agree with the thoughtful comments by Drs Davis and Knaus regarding the moral and economic issues involved in applying sophisticated medical technology to patient care (pp 530 and 531). Our case is an example of the expensiveness of modern technology. The young man whom we described had a severe form of regional enteritis that resulted in numerous medical complications necessitating costly procedures such as total parenteral nutrition, an exploratory laparotomy, abdominal ultrasound studies, and various radionuclide scans in addition to the computerized tomography scans. All of the procedures were based on our clinical impression that the patient's infections, including the terminal brain abscesses, were curable. In my view we, as the physicians responsible for this young man's health, were correct in using optimism as a guiding principle. I recognize that our efforts can be viewed as misguided inasmuch as the young man died