Values In Medicine Flashcards
Value terms
Express value judgements for criteria which are DESCRIPTIVE (or factual)
Value terms used to express widely shared values may come to look like factual terms
Shared values go with sure descriptive criteria for the value judgement in question
eg a widely held value is that a good apple is sweet, which becomes a commonly viewed descriptive term and not a value term
There are areas where values are not always shared.
How can values be applied to the idea of mental disorders?
Mental disorders are much more heavily value laden than bodily disorders.
Bodily disorders are associated with things like pain and death. these are shared values that are bad by anyone’s standards.
Mental disorders are associated with human experiences and behaviours such as emotions, desires, and beliefs. Human values with regard to these, are highly diverse.
Mental disorder then becomes a value term and problem ceases to be a problem in all communities, and begins to reflect the differing values held amongst communities.
For example, in certain African cultures communication with God may not be seen as a mental disorder. in the majority of European cultures it would been seen as a mental disorder.
Linguistic analysis
This is a branch of analytic philosophy developed in the 20th century, that explores the meanings of complex or otherwise problematic concepts through the ways they are used in every day language.
Linguistic analysis includes a number of key ideas that have highly practical applications in mental health and social care, and across healthcare as a whole.
What is a higher level concept?
Higher level concepts are high-level in the sense that they form part of the meanings of many lower level concepts. for example, ‘time’ is a high level concept in that it gives meaning to lower level concepts such as clock, or rhythm.
Higher level concepts are usually difficult to define yet easy to use in every day conversation. The concept of time is difficult to define even though we can use it without any difficulty in conversation.
The concept of a mental disorder is a higher level concept with which philosophy and mental health are concerned.
Hume, facts and values
Hume made a distinction between ‘what is’ - fact, and ‘what ought to be’ - value.
The fact/value distinctions a thin line between what si truth and what is right.
For example, claim X is cruel. is X cruel or does one just view it as cruel? Hare suggests that this is smuggling in a value judgement disguised as a fact.
Medicine and facts
modern medicine has sought to retreat away from value and rely on facts, but this is difficult because clinicians and patients have different values and view the world from different perspectives e.g. mental illness in different communities
the majority of medical decisions involve introduction of values in order to manage facts.
for example, we value the life of humans more than that of bacteria, so we will kill bacteria i order to save the life of a human with a bacteria pneumonia.
aristotle “virtue makes us aim at the right mark, and practical wisdom makes us take the might means”
The concept of health and values
ill health is much easier to define than health
disease is usually defined by pathology, and established with reference to available facts
illness is the patient’s experience of ill health. it is largely subjective within individuals, influenced by psychological and social factors. it is experienced within a life of narrative and not as a scientific construct.
disability results from impairment of function. it is highly subjective, and is partially socially determined -eg. is oscar pistoriofus disabled?
What is health?
WHO defines health as “a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity”.
This bears little relation to the struggles of real people in todays society, and serves merely to extend the biomedical model of heath.
not every deviation from pathology requires treatment - some people view themselves as very healthy!
strength to be and to overcome! ability to flourish! this is a normative model of health, and shifts from optimal form/physiology to optimal function!
