The post-Nuremberg period coincides with the growth of technology-based medicine. Although the Nuremberg Doctrine provided the moral force for transforming consent to medical treatment, the growth of technology determined the direction of this transformation. The interval between the advent of scientific medicine in the late 1890s and the rise of technological medicine in the 1950s was a period with relatively few effective treatments. The patient’s choices were usually limited to one treatment or no treatment at all. Perhaps most important, fewer conditions had been medicalized. Symptomatic disease, rather than laboratory values, drove patients to seek treatment.

In this context, patients expected physicians to make all necessary medical decisions. This was an extension of the traditional paternalistic physician–patient relationship. It was also a reasonable response. The decision on treatment was based mostly on technical medical considerations. Without the luxury of several effective treatments, the paternalistic model of medical decision making did not deprive patients of meaningful autonomy.