In reply: Russell implies that my recent column on the boundaries of medicine1 conveys the premise that medicine is a defined and discrete discipline underpinned by biomedical science. So it did, but the contention is not mine, it is that of Seldin.2

However, no one would deny that biomedical knowledge is the best developed and most powerful component of modern medicine; nor would they deny that there are other intrinsic components, such as the art of caring.3

My argument is that the boundaries between medicine and health have become blurred with modernity's overwhelming homage to health.4 Furthermore, the very nature of health is difficult to define, shaped, as it is, by variable psychological, socioeconomic and cultural factors.

If, in fact, health is the World Health Organization's utopian "the complete [my emphasis] physical, psychological and social well being", then most of us are unhealthy.5

My purpose was to question the boundaries of medicine and health. In particular, to question where the responsibility for attaining the modern Shangri-La of health rests — with the individual, society or medicine?