Bearing values on clinical decisions.
Psychiatry is more value-laden than any other field of medicine because it is concerned of human experience and behavior. It is natural that psychiatry should recognize the role of values, alongside facts, in all areas of clinical practice-diagnosis, treatment and rehabilitation. There is a considerable concern on the development and the current form of evidence-based psychiatry whether this being sufficient in decision making in complex environment of mental health services of today. Psychiatric diagnosis derived from observed symptoms silence the interpersonal dialogues. The clinical encounter is narrowly focused on the forms instead of contents, meanings and background of human mental distress. We need a complementary value model, value-based approach, which runs parallel to evidence-based psychiatry. Value-based approach, like evidence-based, is a resource for effective decision-making in psychiatric practice. It starts from equal respect for all values, individual patients, their families and communities, and the recognition of the fact that various value terms already exist in DSM or ICD diagnostic systems. To respect values, psychiatry must step down to be equal with service users. Current development of mental health services are based on the principles of patient centered decision-making and multidisciplinary teamwork. This should provide basis for value-based as well as fact-based psychiatric practice.
Lee
Ho Young
HY
Dasarang Center Hospital.
D003657:Decision Making; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis; D018802:Patient-Centered Care; D011570:Psychiatry / Q000193:education / Q000592:standards*