Needs, Wants, Demands, and Interests

Their Interaction in Medical Practice and Health Policy
  • Jerry Avorn
Part of the The Hastings Center Series in Ethics book series (HCSE)


The Hastings Center Working Group on Ethics and Health Policy began its work in the late 1970s at a time when it still seemed plausible for adult men and women to sit together and discuss what goals the American health care system might set for itself and how we as a nation might most justly accomplish these goals. Now, in the early 1980s, in the midst of an unprecedented retrenchment in health care programs and other public services, it seems somewhat naive to address these questions with anything but a heavy sense of irony. Nonetheless, it is still useful to consider the relationship between health needs, health care wants, and interests in the formulation and delivery of medical services with the hope and expectation that within the next few years the allocation of resources to meet human needs once again will become an important part of the national agenda.


Health Maintenance Organization Health Care Delivery System American Health Care Health Care Demand Annual Physical Examination 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    World Health Organization, “The Constitution of the World Health Organization,” WHO Chronicle I (1947), 29.Google Scholar
  2. 2.
    Daniel Callahan, “The WHO Definition of ‘Health,’” Hastings Center Studies,Google Scholar
  3. I (1973), 77–87.Google Scholar
  4. 3.
    A. L. Cochrane, Effectiveness and Efficiency: Random Reflections on Health Services (London: Nuffeld Provincial Hospitals Trust, 1972).Google Scholar
  5. 4.
    Arthur L. Caplan, “Kidneys, Ethics, and Politics: Policy Lessons of the ESRD Experience,” Journal of Health Politics, Policy, and Law, VI (1981), 488–503.CrossRefGoogle Scholar
  6. 5.
    Richard A. Rettig, “The Policy Debate on Patient Care Financing for Victims of End-Stage Renal Disease,” Law and Contemporary Problems, XL (1977), 196–230.Google Scholar
  7. 6.
    Earl L. Koos, The Health of Regionville (New York: Columbia University Press, 1952).Google Scholar
  8. 7.
    Robert N. Butler, Why Survive? Growing Old in America (New York: Harper & Row, 1975).Google Scholar
  9. 8.
    James Groves, “Taking Care of the Hateful Patient,” New England Journal of Medicine, CCXCVIII (April 20, 1978), 883–87.CrossRefGoogle Scholar
  10. 9.
    See Mark Siegler (Chapter 9) in this volume.Google Scholar
  11. 10.
    Avedis Donabedian, Aspects of Medical Care Administration (Cambridge, Mass.: Harvard University Press, 1973).Google Scholar
  12. 11.
    Howard Becker et al., Boys in White: Student Culture in Medical School (Dubuque, Iowa: William C. Brown, 1972).Google Scholar
  13. 12.
    Victor Fuchs, Who Shall Live? Health, Economics, and Social Choice (New York: Basic Books, 1974).Google Scholar
  14. 13.
    Claude Lévi-Strauss, Structural Anthropology (New York: Basic Books, 1963), chap. 9.Google Scholar
  15. 14.
    Daniel H. Funkenstein, Medical Students, Medical Schools, and Society During Five Eras (Cambridge, Mass.: Ballinger Publishing Company, 1978).Google Scholar
  16. 15.
    Robert K. Merton, G. G. Reader, and P. L. Kendall, eds., The Student Physician (Cambridge, Mass.: Harvard University Press, 1957).Google Scholar
  17. 16.
    Eugene Vayda, “A Comparison of Surgical Rates in Canada and in England and Wales,” New England Journal of Medicine, CCLXXXIX (1973), 1224–29.CrossRefGoogle Scholar
  18. 17.
    Thomas L. Delbanco and William C. Taylor, The Periodic Health Examination,” Annals of Internal Medicine, XCIII (1980), 773–75.Google Scholar
  19. 18.
    Mick Jagger et al., Let It Bleed, (1969).Google Scholar

Copyright information

© The Hastings Center 1983

Authors and Affiliations

  • Jerry Avorn
    • 1
    • 2
  1. 1.Social Medicine and Health Policy, Division on AgingHarvard Medical SchoolUSA
  2. 2.Beth Israel HospitalBostonUSA

Personalised recommendations