In reply: Boundaries of medicine

In reply: I thank Sir Keith for his pragmatic proposal. The concept of health has individual and societal connotations. At its most basic level, it is the avoidance of pain and suffering. More broadly, it is a basic human resource for the pursuit of life's goals.1 But, as argued by Lewis and Leeder, "health is a good to be pursued, but not an absolute one" for the "functioning of social institutions does not require perfectly healthy citizenry, nor does the individual have to be perfectly healthy to take part in social life."2 As such the perfect definition of health espoused by the WHO is Utopian and removed from reality. It is, as poignantly captured by René Dubos, the "mirage of health", as "complete freedom . . . from disease is but a dream remembered from imaginings of a Garden of Eden."3