In Britain matters of clinical judgement and practice rarely become the subject of political action and are usually not covered by legislation, but rather by'guidelines' and well-meaning persuasion. In California, however, where the medical and dental professions are not trusted to put their own house in order, everything is covered by legislation and becomes the subject of intense political lobbying. The giving of general anaesthesia by dentists has been tightly governed since 1980 but the legislature has only just come to grips with the question of conscious sedation