NEEDS AND MEDICINE

ABSTRACT. It is argued that human needs are not facts (properties, states, processes, relations) about people, but are values. The reasons presented for this position are (1) that needs are goal oriented and goals are things people value, (2) that 'need ' functions as a basic motivational term, and (3) that dis-agreements about what people need are disagreements in attitude toward, and emotional attachment to, things variously considered to be valuable. If human needs are not facts, then, of course, health or medical needs are not. Viewing health or medical needs as discoverable facts, rather than values, engenders certain difficulties in the following areas of concern: (a) Deciding when surgery is necessary and when unnecessary; (b) Defining the concepts of health and disease; (c) Evaluating some consequences of the development of medical science and technology; and (d) Understanding the alleged conflict between patients' health needs and their human rights. John Wisdom once suggested that philosophers do not discover new facts, but help people see old facts in a new way. Philosophers also may help people realize that what is sometimes thought to be a fact, old or new, may not be a fact at all. I shall argue that it does not make good sense to think of human needs as facts. Assuming the argument successful, I will then indicate some implications this has for the notion of health needs and for the medical profession. Medical professionals, like practically everyone else, tend to think of needs as facts about people. Doctors, we are told, are less concerned with the values of persons than with their diseases. George Annas notes that "physicians usually express this by saying that they ar