As families and medical staff assimilated the consequences of the life-support

technology represented by the artificial respirator that could prolong dying or life without

cognition, they reached out to the ethical traditions of religion, medicine, and society for

help (Pius XII, pp. 501–504). Physicians particularly began to see that the ethical

problems to be solved in these crises were as great as or greater than the technical

problems of treatment. Other machines developed in this period posed a similar mix of

ethical and technical issues. The artificial kidney was created as a device for acute,

intermittent dialysis by Willem Kolff in The Netherlands in 1944 but it was introduced as

a clinically usable machine in the early 1960s in Seattle, Washington, by Belding

Schribner. The limited number of machines and personnel to run them led to moral

agonizing over developing criteria for selection. Technologies such as the artificial

kidney and the respirator have been criticized as offering expensive but partial solutions

to fundamental problems of biologic breakdown.

The extraordinary and growing expense of the healthcare system that followed the

development of such technologies may be reduced when biomedical research produces

comprehensive biologic answers to problems such as organ failure. But in the twentieth

century, we have acquired few such complete technologies. One group, already

mentioned, is penicillin and other antibiotics, which offer total solutions, that also are

inexpensive and rapidly acting, to the problems of bacterial infection. A second generic

complete technology is the vaccine. Those invented to prevent smallpox (first

introduced in the eighteenth century) and poliomyelitis (developed in the mid-1950s)

have in the twentieth century eradicated the first disease and almost wholly contained

the second.
The emerging field of genetic research promises fundamental solutions to a host of

disorders, with the prospect of their early detection and correction. Finally, the growing

ability to visualize the basic structures of the body through endoscopes and computer-

driven imaging machines such as the MRI and PET scans provides diagnostic

knowledge facilitating the use of therapeutic technologies that promise complete cures.

Indeed, genetic and imaging technologies have taken the anatomic concept of illness to

its ultimate terminus. To the question "Where is the disease?" the answer now can be

"In this particular gene!"