01867nas a2200325   4500000000100000008004100001260000900042653003900051653002000090653001800110653002000128653003400148653001100182653002100193653001200214653002300226653002200249653001300271653002400284653001800308653002400326653002300350100001600373700001600389245004000405300001100445490000700456520106400463022001401527       1987                            d  c198710aAcquired Immunodeficiency Syndrome10aConfidentiality10aFluid Therapy10aHealth Services10aHealth Services Accessibility10aHumans10aInternationality10aleprosy10aMandatory Programs10aMoral Obligations10aPolitics10aPrimary Health Care10aPublic health10aResource Allocation10aVoluntary Programs1 aGoodman M J1 aGoodman L E00aMedicalization and its discontents.  a733-400 v253 a<p>This paper raises the question of the ethically proper balance in health care policy between the medical-clinical-high technology model of health service and the grass-roots, community based or traditional models of care. Paradoxical imbalances between the two approaches are traced to political, economic or prestige factors. Case studies examined include the hospitalization of non-contagious leprosy patients while protecting the anonymity of AIDS-infected prostitutes, medical resistance to the adoption of a clinical role by Community Cancer Centers, and the continued preference in some quarters for elaborate (and often delayed) hospital treatment for such problems as infant diarrhea, despite the availability of much simpler solutions, as in the case of the widely successful oral rehydration therapy. A balanced approach to world health problems, we argue, rests not on inflationary lowering of health care standards to achieve nominal victories, nor on stainless steel high technology panaceas but on mobilizing resources around human needs.</p>  a0277-9536