Overstating values: medical facts, diverse values, bioethics and values-based medicine

Parker, Malcolm (2013) Overstating values: medical facts, diverse values, bioethics and values-based medicine. Bioethics, 27 2: 97-104. doi:10.1111/j.1467-8519.2011.01902.x

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Author Parker, Malcolm
Title Overstating values: medical facts, diverse values, bioethics and values-based medicine
Journal name Bioethics   Check publisher's open access policy
ISSN 0269-9702
Publication date 2013-02-01
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1467-8519.2011.01902.x
Open Access Status Not yet assessed
Volume 27
Issue 2
Start page 97
End page 104
Total pages 8
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Abstract Fulford has argued that (1) the medical concepts illness, disease and dysfunction are inescapably evaluative terms, (2) illness is conceptually prior to disease, and (3) a model conforming to (2) has greater explanatory power and practical utility than the conventional value-free medical model. This ‘reverse’ model employs Hare's distinction between description and evaluation, and the sliding relationship between descriptive and evaluative meaning. Fulford's derivative ‘Values Based Medicine’ (VBM) readjusts the imbalance between the predominance of facts over values in medicine. VBM allegedly responds to the increased choices made available by, inter alia, the progress of medical science itself. VBM attributes appropriate status to evaluative meaning, where strong consensus about descriptive meaning is lacking. According to Fulford, quasi-legal bioethics, while it can be retained as a kind of deliberative framework, is outcome-based and pursues ‘the right answer’, while VBM approximates a democratic, process-oriented method for dealing with diverse values, in partnership with necessary contributions from evidence-based medicine (EBM). I support the non-cognitivist underpinnings of VBM, and its emphasis on the importance of values in medicine. But VBM overstates the complexity and diversity of values, misrepresents EBM and VBM as responses to scientific and evaluative complexity, and mistakenly depicts ‘quasi-legal bioethics’ as a space of settled descriptive meaning. Bioethical reasoning can expose strategies that attempt to reduce authentic values to scientific facts, illustrating that VBM provides no advantage over bioethics in delineating the connections between facts and values in medicine.
Keyword Bioethics
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 29 JUL 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 30 Aug 2011, 22:25:40 EST by Matthew Lamb on behalf of School of Medicine