This article raises, but does not answer, the kinds of questions that need to be asked by responsible occupational therapists in the 1980s—ethical questions that deal with technological advances on the one hand and limited resources on the other. The article examines moral dilemmas that practitioners and students face when making clinical decisions in a climate where technology and cost containment may overshadow the needs of the individual patient. A review of the literature on clinical reasoning, technology, and cost containment provides the background for a discussion of specific issues of quality of life for the occupational therapist. Implications for education and practice are presented, with suggestions for further consideration.