Medical Axiology and Values

Values are the foundation upon which any ethic, including bioethics, is established. The values that both patients and healthcare providers hold or subscribe to influence not only contemporary medical knowledge and practice but also the use of that knowledge and its practice. Values serve fundamentally to define not only what is of proximate-but also of ultimate-worth. They “are concepts we use to explain how and why various realities matter. Values are not to be confused with concrete goods. They are ideas, images, and notions. Values attract us” (Ogletree, 2004, p. 2540). Besides values, there are also disvalues that define what is of no value. “Disvalues,” according to Thomas Ogletree, “express what we consider undesirable, harmful, and unworthy about a particular phenomenon. They identify realities that we resist or strive to avoid” (2004, p. 2540).

Basically, then, values and disvalues are what under gird human behavior and are intimately associated with human need. “Behind our passions, interests, purposive actions,” claims Samuel Hart, “is the belief that they are worthwhile” (1971, p. 29). Values and disvalues serve as motivating factors in promoting or inhibiting human action. For example, the value of health and the disvalue of disease can be an incentive to eat certain foods low in cholesterol and to avoid those high in it. The study of values and of the theories used to explicate them is the part of philosophy called axiology. “Axiology,” as Barry Smith and Alan Thomas define it, “is the branch of practical philosophy which seeks to provide a theoretical account of the nature of values, whether moral, prudential or aesthetic” (1998, p. 609). Although the study of values has a long tradition within western philosophy- beginning particularly with the Greeks who examined such values as the good, the beautiful, or the virtuous-the programmatic or scientific study of values was not introduced until the late nineteenth century, especially by the Austro-German school (Smith and Thomas, 1998; Rescher, 1969).