Needs, need, needing.

作者：D. M. Wiggins, S Dermen · 发表于：Journal of Medical Ethics · 年份：1987 · DOI：10.1136/jme.13.2.62 · 被引用次数：83 · 研究领域：Health Services Management and Policy、Healthcare Policy and Management、Ethics in medical practice

It is a pervasive assumption that the proper basis for medical care is medical need.A further assumption that doctors and administratorsfrequently make is that medical resources ought to be distributed according to medical need.But what is need?In this paper it is argued that there are two concepts ofneed, often conflated.One is an elliptical and instrumental concept -that ofneed relative to some specified or specifiable desired end.The other concept is that ofa need taken in a categorical or absolute sense.It is with this that the author begins, claiming that it can be defined in terms ofthe relative sense, and suggesting that in the context ofjustifying rights and imposing duties, including those relating to health care, it is the categorical concept and its various further deterninations that are important.1. Need is often thought of as desire of a special kind, (for example, rational desire or strong desire, or whatever).But how can this be right?Certainly need will often find its characteristic expression in desire.But since this expression will sometimes be markedly inadequate to the need itself, it is hard to believe that needs as such are the same as desires, or that needing as such is the same as any sort of desiring.It may be suggested that a need is some sort of a corrected desire: but to make this idea work would involve much elaboration of the requisite 'correction', while drawing relatively little upon the idea of desire.(Nor would the suggestion save the extrav...