Why is all this important? Well, it shows us that health and disease, are to a large extent value judgements, based on what people are currently prepared, or not prepared to accept as a cost of living. The �hard science� of medicine is, in large part, illusionary. Science is not value free, and medicine much less so. Values change, often with alarming rapidity. When this happens, accepted �truth� also changes.

This illusion allows us to think that both doctors and patients have the same expectations about conduct (they don�t), behaviour (rarely) and outcomes (almost never). It has been said that �In reality, there are no diseases, only sick patients�.