REFERENCE IN HEALTH libraries must provide LIBRARIANS SCIENCES accurate and up-to-date information in a timely fashion in response to the patient care and research needs of the health care profession. Discussed here are some of the issues involved in the provision of such services: quality of service, access to information, confidentiality, intellectual freedom, and liability. Although technologies such as online information retrieval, telefacsimile, and CD-ROM have improved access to information, they create their own problems, including potential for censorship and equal access to information. End-user searching raises new questions related to quality and information access.