Abstract
BackgroundRecent scientific developments, along with growing awareness of cultural and social diversity, have led to a continuously growing range of available treatment options; however, such developments occasionally lead to an undesirable imbalance between science, technology and humanism in clinical practice. This study explores the understanding and practice of values and value clusters in real-life clinical settings, as well as their role in the humanization of medicine and its institutions. The research focuses on the values of clinical practice as a means of finding ways to enhance the pairing of Evidence-Based Medicine (EBM) with Values-based Medicine (VBM) in daily practice.Methods and findingsThe views and representations of clinical practice in 15 pre-CME and 15 post-CME interviews were obtained from a random sampling of active healthcare professionals. These views were then identified and qualitatively analyzed using a three-step hermeneutical approach.A clinical values space was identified in which ethical and epistemic values emerge, grow and develop within the biomedical, ethical, and socio-economic dimensions of everyday health care. Three main values—as well as the dynamic clusters and networks that they tend to form—were recognized: healthcare personnel-patient relationships, empathy, and respect. An examination of the interviews suggested that an adequate conceptualization of values leads to the formation of a wider axiological system. The role of clinician-as-consociate emerged as an ideal for achieving medical excellence.ConclusionsBy showing the intricate clusters and networks into which values are interwoven, our analysis suggests methods for fine-tuning educational interventions so they can lead to demonstrable changes in attitudes and practices.
Highlights
The evidence-based medicine–Values-based medicine paradigmTwo major models have become dominant in recent years as frameworks for the practice of medicine: Evidence-Based Medicine (EBM) and Values-Based Medicine (VBM)
In the case of medical practice epistemic values are central in evidence-based medicine finding the cause of an illness is very important, values-based medicine includes ethical values involved in the consequences of treatment for a patient’s life and the decisions surrounding it are essential
The three-step interpretative process of the interview transcriptions recorded before and after the Continuing Medical Education (CME) course reveals the system of values that is at work among active clinicians and notes new horizons for its expansion
Summary
Two major models have become dominant in recent years as frameworks for the practice of medicine: Evidence-Based Medicine (EBM) and Values-Based Medicine (VBM) While the former emphasizes systematic research aided by technological advancement as the basis for clinical decision making; the latter focuses on linking scientific evidence to the specific and sometimes conflicting values operating on both the patient’s side as well as the clinicians’ side during treatment [1]. To effectively fulfill the ends of medicine, i.e., healing, curing and caring [2], it is paramount that a comprehensive approach that successfully unifies the evidencebased and values-based practices is established. The need for such an approach is recognized by active healthcare professionals as well as members of the academic community. The research focuses on the values of clinical practice as a means of finding ways to enhance the pairing of Evidence-Based Medicine (EBM) with Values-based Medicine (VBM) in daily practice
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