Medical consumerism-like all sorts of consumerism, only more menadngly is designed to be unsatisfying. (51) {{U}}The prolongation of life and the search for perfect health (beauty, youth, happiness) are inherently self-defeating{{/U}}. The law of diminishing returns necessarily applies. You can make higher percentages of people survive into their eighties and nineties. But, as any geriatric ward shows, that is not the same as to comer enduring mobility, awareness and autonomy. (52) {{U}}Extending life grows medically feasible, but it is often a life deprived of everything, and one exposed to degrading neglect as resources grow over-stretched and politics turn mean{{/U}}.
What an ignominious destiny for medicine if its future turned into one of besowing meager increments of unenjoyed life! It would mirror the fate of athletics, in which disproportionate energies and resources-not least medical ones, like illegal steroids-are now invested to shave records by milliseconds. And, it goes without saying, the logical extension of longevity-the "abolition" of death-would not be a solution but only an exacerbation. (53) {{U}}To air these predicaments is not anti-medical spleen-a churlish reprisal against medicine for its victories{{/U}}-but simply to face the growing reality of medical power not exactly without responsibility but with dissolving goals.
(54) {{U}}Hence medicine's finest hour becomes the dawn of its dilemmas.{{/U}} For centuries, medicine was impotent and hence unproblematic. From the Greeks to the Great War, its job was simple: to struggle with lethal diseases and gross disabilities, to ensure live births, and to manage pain. It performed these uncontroversial tasks by and large with meager success. Today, with mission accomplished, medicine's triumphs are dissolving in disorientation. (55) {{U}}Medicine has led to vastly inflated expectations, which the public has eagerly swallowed{{/U}}. Yet as these expectations grow unlimited, they become unfulfillable. The task facing medicine in the twenty-first century will be to redefine its limits even as it extends its capacities.