Values in health care

Soc Sci Med. 1984;19(4):333-9. doi: 10.1016/0277-9536(84)90190-4.


The first part of the paper is concerned with the health care values of various groups; namely, those which are resource oriented, disease oriented, political decision-makers, organized sellers and purchasers of health care and patients. These groups are further divided according to selected political/ideological and socio-economic characteristics, essentially along capitalist and socialist lines. Some of the ways in which the values held by these groups are determined, formulated and, by implication at least, changed and the political, economic and other bases for some of their practical applications are identified. The second part of the paper focuses upon values in public health education and related practice. It is argued that to become more useful to the 'health of the public' the new public health worker will have to become more activist, assuming an adversarial stance toward the market economy in capitalist countries and oppressive governmental structures everywhere. A wider integration of knowledge concerning the effects of health of all types of economic, social and political practices is required; this, in turn, would contribute to the emergence of alternative forms of public health analysis and practice. The recognition of wider forms of public health leadership should follow, coupled with organizational changes directed at the greater participation of popular groupings in all types of public health activities.

KIE: In the first part of his paper, Gish identifies and discusses the health care values of five groups: the resource oriented, such as planners and economists; the disease oriented, such as physicians; political decision makers; organized sellers and purchasers of health care, such as insurers and trade unions; and patients and their families. He further divides the groups according to certain political/ideological and socioeconomic characteristics, essentially along capitalist and socialist/Marxist lines. The second part of the paper focuses on values in public health education and practice. Gish urges public health professionals to assume an adversarial stance vis-à-vis the market approach to health care in capitalist countries. An activist approach is necessary, he argues, to the development of healthier, more democratic societies, defined by Gish as socialist societies.

MeSH terms

  • Capitalism
  • Delivery of Health Care / organization & administration*
  • Health Education / trends
  • Health Policy / trends*
  • Health Resources / trends
  • Humans
  • Internationality*
  • Politics
  • Public Health / trends
  • Resource Allocation
  • Social Values*