Medical Ethics is too ancient and too essential a reality in the lives of physicians, patients, and society to he left entirely to the fortuitous currents of philosophical fashion or the unsupported assertions of clinicians.1
— EDMUND D. PELLEGRINO, M.D.
As much as we may admire the therapeutic and ethical achievements of the Hippocratic physicians and their successors in Greece and Rome, most agree that the physician-patient relationship has undergone many significant changes since antiquity. Much of this change is due to the comparatively recent invention and application of automated medical technologies and experimental drug therapies in the treatment of disease. For example, in ever more instances, physicians can keep brain-dead patients “alive,” or patients in persistent vegetative states functioning almost indefinitely through the use of respirator and related life-support technologies that sustain breathing and circulation. Many of these patients would have died of their afflictions straightaway in earlier, pretechnological times. In Aristotle's Athens, the average age of mortality was approximately forty.2 What's more, this ethically perplexing state of affairs in critical care medicine has been realized by a vast array of new machines, including fully coordinated monitors, powerful radiologic and chemical therapies, microsurgical robotic techniques, customized artificial limbs and joints, as well as donor and mechanical organ substitutes.
In stark contrast, the ancient physician did not face the awesome problem of being able to prolong a patient's life indefinitely. He lived during a comparatively pretechnological period, when the latest advances in medical technology included new forms of bandaging, drug and dietary measures, pain-relieving surgical maneuvers, or the application of palpating techniques. He had no occasion,