Supplement Article: PDF OnlyAcademic health centers and society an ethical reflectionPellegrino, E DAuthor Information Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC 20007, USA. Created Date: 21 October 1999; Completed Date: 21 October 1999; Revised Date: 20 February 2002 Academic Medicine: August 1999 - Volume 74 - Issue 8 - p S21-6 Free Abstract Academic health centers--which combine university, medical school, and hospital--exist to satisfy universal human needs and thus are by definition instruments of social purpose. Their core mission is threefold: to provide medical knowledge that can help relieve and prevent illness and suffering, to supply practitioners able to apply that knowledge wisely, and to serve as sites where optimal use of medical knowledge can be demonstrated and investigated. Maintaining a balance between core mission and responsiveness to social trends is a delicate exercise. Overly close accommodation to such trends can endanger the core mission, as has occurred in the United States with regard to managed care. Society and academic health centers have mutual obligations. Obligations of society include giving academic health centers financial and other support and allowing them sufficient freedom to pursue their mission; obligations of academic medical centers include accepting greater scrutiny by society and providing social criticism on matters relating to health. A task for the future is to discern how academic health centers can be responsive to social needs without being totally subservient to societal desires. © 1999 Association of American Medical Colleges