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Medical judgment can be taught - laboriously, in long periods of training - but it cannot be neatly handed over as the occasion demands it. It is the irreplaceable and untransferable contribution that the healer makes to the suffering individual who would be healed.

Medical knowledge and technical savvy are biodegradable. The sort of medicine that was practiced in Boston or New York or Atlanta fifty years ago would be as strange to a medical student or intern today as the ceremonial dance of a !Kung San tribe would seem to a rock festival audience in Hackensack.

Medical need is an infinitely expandable concept. There is always one more marginal procedure that can be done. There is no end to the medical and surgical treatments that a technologically sophisticated and advanced society can give to aging bodies.