Values-based practice and phenomenological psychopathology: implications of existential changes in depression

Authors
Anthony Vincent Fernandez
Kent State University
Abstract
Values-based practice (VBP), developed as a partner theory to evidence-based medicine (EBM), takes into explicit consideration patients’ and clinicians’ values, preferences, concerns and expectations during the clinical encounter in order to make decisions about proper interventions. VBP takes seriously the importance of life narratives, as well as how such narratives fundamentally shape patients’ and clinicians’ values. It also helps to explain difficulties in the clinical encounter as conflicts of values. While we believe that VBP adds an important dimension to the clinician’s reasoning and decision-making procedures, we argue that it ignores the degree to which values can shift and change, especially in the case of psychiatric disorders. VBP does this in three respects. First, it does not appropriately engage with the fact that a person’s values can change dramatically in light of major life events. Second, it does not acknowledge certain changes in the way people value, or in their modes of valuing, that occur in cases of severe psychiatric disorder. And third, it does not acknowledge the fact that certain disorders can even alter the degree to which one is capable of valuing anything at all. We believe that ignoring such changes limits the degree to which VBP can be effectively applied to clinical treatment and care. We conclude by considering a number of possible remedies to this issue, including the use of proxies and written statements of value generated through interviews and discussions between patient and clinician.
Keywords Depression  Evidence-Based Medicine  Phenomenology  Values  Values-Based Practice
Categories (categorize this paper)
Reprint years 2015
DOI 10.1111/jep.12313
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

Our Archive
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

The Philosophy of Evidence-Based Medicine.Jeremy Howick - 2011 - Wiley-Blackwell, Bmj Books.

View all 13 references / Add more references

Citations of this work BETA

Add more citations

Similar books and articles

Psychopathology.E. Keen - 1978 - In Ronald S. Valle & Mark King (eds.), Existential-Phenomenological Alternatives for Psychology. Oxford University Press. pp. 234--264.
Which Values? And Whose? A Reply to Fulford.Bob Brecher - 2011 - Journal of Evaluation in Clinical Practice 17 (5):996-998.
Values‐Based Medicine and Modest Foundationalism.Miles Little, Wendy Lipworth, Jill Gordon, Pippa Markham & Ian Kerridge - 2012 - Journal of Evaluation in Clinical Practice 18 (5):1020-1026.

Analytics

Added to PP index
2015-04-03

Total downloads
137 ( #44,711 of 2,293,895 )

Recent downloads (6 months)
21 ( #21,259 of 2,293,895 )

How can I increase my downloads?

Monthly downloads

My notes

Sign in to use this feature