Professor Maiorca: Right from the start, the clinical application of dialysis raised important ethical problems arising from the need to select, among several candidates, the few patients to benefit from the scanty resources available. Following its establishment, over more than three decades dialysis grew impressively and nowadays more than 650 000 patients are kept alive by this therapy, while as many more survive thanks to transplantation of a functioning kidney. Yet even today 75% of dialysis resources are reserved for only 15% of the world's population, and in many countries the sole alternative to dialysis is death or, at best, a purchased transplantation. If in a number of developing countries patients die of uraemia, in the economically developed nations access to dialysis differs widely according to a variety of factors, not all of them clear-cut but for the most part of an economic nature. In these countries discussion is ongoing as to whether it is ethical to limit access to dialysis, considering the costs of treatment and the need for a general equity in the distribution of health resources. There is also discussion of an opposite problem, namely whether in certain cases it may be fitting to assent to death by suspension of dialysis when the patient, burdened by the superimposition of a number of disease events, is tired of carrying on with dialysis which only prolongs a life of suffering. In order to discuss this and other problems, we have invited a well-known nephrologist, Professor Quirino Maggiore; a bioethicist, Dr Mordacci, working at the San Raffaele Hospital in Milan; the District Health Administrator for the Emilia-Romagna region, architect Giovanni Bissoni; one of Italy's leading journalists and opinion-makers, Enzo Biagi; and the well-known, much-loved priest, His Eminence Cardinal Ersilio Tonini. Our warmest thanks to them for accepting the invitation of the Organizing Committee and for expressing their points of view on topics not familiar to all of them.