Advances and Challenges.

American medicine in the 1990s underwent great technological advances in areas ranging from plastic surgery to techniques that greatly improve a person's vision. General surgery, which had been a shrinking specialty, achieved new heights with advances led by the development of small incisional and endoscopic surgical procedures. Rapid improvements in medical technology, however, raised troubling ethical and legal questions. Attempts to define precisely the moment that a life begins and ends went from research labs into the courtrooms and, ultimately, became the subject of television talk shows and political debate. The AIDS epidemic, first identified in the 1980s, continued, along with a resurgence of infectious diseases such as tuberculosis, which had been thought to have been eradicated. As the population aged and health care became more expensive, the political and economic consequences of every health-care decision became subject to drawn-out national debate.

Testing Difficulties.

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