Just a quick note to thank all the respondents to my question for your very thoughtful replies thus far. I get the Digest, and have just finished reading those which were not copied to me personally, like Lori's and Andrew's.
I pull a 12-hour day (13-1/2, if you figure in my commute) as a Patient Care Technician in a hospital, without computer access, so my ability to post is almost nonexistent. I do catch up with the JMDL Digest as often as I can, however, either on days off or early in the morning with coffee before showering for work. I look forward to more of this discussion, should it continue. Again, thanks - for your compliments regarding the merits of the question, and for finding it thought-provoking and worthy of reply. It really has been something I've wondered about for a long time, and, thanks to you folks for sharing your insights and theories, I'm beginning to understand. Best, Jim