Stephen Pattison, Ben Hannigan, Roisin Pill and Huw Thomas (eds)

London: Jessica Kingsley Publishers, 2010, 253 pp with index, £39.99, ISBN 978-1-84310-947-1 (sbk)

Cite as: S H E Harmon, “Book Review: Emerging Values In Health Care: The Challenge For Professionals”, (2012) 9:1 SCRIPTed 120 http://script-ed.org/?p=339

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DOI: 10.2966/scrip.090112.120

© Shawn H E Harmon 2012.

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.5 UK: Scotland License.

According to the editors of Emerging Values in Health Care, “values” are important both generally and to the healthcare setting and its various and changing professionals, and they become more important, or at least more visible and subject to discussion and refinement, when people and institutions find themselves in periods of rapid or ongoing change (pp.11 and 15).  This proposition is both reflected in, and bolstered by, research conducted at the University of Edinburgh on the importance and operationalisation of values in the broad health research setting.[1]

The editors define values generally as being integral to our understanding of the world. They guide our behaviour, attitudes, and actions in the world (i.e. they help to shape our understandings of our place or identity within the world) and their articulation is largely in keeping with a more detailed definition of values offered elsewhere which sees them as universal, socially constructed, and reflecting the following mutually-enhancing propositions:^[2]

• Values are concepts and virtues worthy of esteem in and of themselves because they support human flourishing, both individual and collective; they are ideas or ideals about what is good and right, and they are inextricably linked to respect for persons, fulfilment of basic needs, and development of personality.
• Values are an amalgam of high-level or abstract morally-founded ideas or ideals that can be disembodied from the specific, but from which action-guides beyond interests can be distilled, and through which human life and activities can be evaluated; they are the underlying attitudes or expectations which tend to justify the elevation of human life above other life, and to promote the wellbeing of, and respect for, persons.
• Values contribute to personal identity in that they are deeply held and so constitutive of the self. When they are shared or commonly understood, they additionally contribute to social identity because they encourage the forming of bonds with others. As such, they partially form (or inform) the overall social environment (in this case the biomedical research and healthcare setting).

Unfortunately, while the individual chapters of this book are very well written, richly researched and informative, and commendably edited (and therefore effectively integrated), they do not proceed from any clear or shared understanding of the term “values”, a fact which is conceded by the editors (p. 230-231).

Finally, the editors claim that values can perform a number of functions, including the following:

• legitimising action and organisational arrangements;
• coordinating individual and institutional actions;
• managing and disciplining workers;
• justifying change and/or resistance to change; and
• creating and consolidating identity.

Again, these propositions are supported by research conducted through the University of Edinburgh on values in the regenerative medicine setting.[3]  Moreover, given the importance and potential role of values in regulating human activities, particularly those in the health context,[4] much more empirical research is warranted on the formation and operationalisation of values.  Emerging Values in Health Care is an excellent early contribution to this cause.

The editors assert that the book arose from a dialogue between an interdisciplinary and inter-professional group of experts which included doctors, nurses, psychologists and pharmacists, philosophers, theologians and clergy, and individuals from the humanities, and the book is enriched by that diversity of perspectives. The eleven chapters, which are preceded by a useful scene-setting Introduction, address a range of health professions or specialisations relevant to healthcare management. Using values as an analytical cornerstone, they examine the UK’s NHS, a focus which may limit interest in the book,[5] but which functionally grounds the case studies and makes them more concrete and practical.  Adding to their value, most of the chapters are accompanied by very useful critical responses.

This book acknowledges and reflects on the complexity that pervades the healthcare setting, and the growing importance of values thereto.  Through its case studies, all of which are interesting and readable, it highlights how values help in identity formation but are also left un-operationalised (i.e. values are not realised through workplace behaviour, which is changing as the health service is increasingly fragmented and populated by competing professions with varying degrees of self-identity and uniformity of same).  As a resource, as noted elsewhere,[6] Emerging Values in Health Care should be useful to healthcare professionals (in their training or continuing education), but also to a wider collection of medical and humanities scholars, including, importantly, lawyers and health-related policymakers who are tasked with key roles in shaping the health setting and its boundaries, and the behaviours of those operating therein.

Shawn HE Harmon,

InnoGen, ESRC Centre for Social and Economic Research on Innovation in Genomic
SCRIPT, AHRC Centre for Research in Intellectual Property and Technology Law
University of Edinburgh, UK