Former post-doctoral fellows at the Centre for the Humanities and Health, Dr Elselijn Kingma and Dr Natalie Banner have recently re-considered the philosophical core of values-based medical practice in their chapter “Liberating practice from philosophy: a critical examination of values-based practice and its underpinnings,” in Dr Michael Loughlin (ed. by), Debates in Values-Based Practice. Arguments For and Against, Cambridge University Press (Oct. 2014).
As they explain in the introduction to their investigation,
Values Based Practice (VBP) has been developed and promoted by Bill Fulford over the past 20 years. In this chapter we investigate the relationship between the practical, skill-based aspects of VBP and its supposed philosophical basis. Firstly, we argue that the practical, skills-based and educational aspects of VBP do not require the philosophical underpinnings and commitments that Fulford packages them with. Instead, most of the practical aspects of VBP are compatible with a wide range of positions on philosophical methodology and a wide range of substantive philosophical claims. Secondly we argue – drawing upon a range of published objections, adding some of our own – that there are severe problems with the philosophical claims Fulford commits to. Thirdly, we point out that these philosophical commitments do not in fact derive from OLP at all, which plays a much smaller role in VBP than Fulford claims. We conclude that most of the practical, skills-based and educational aspects of VBP – which seem, as far as we can judge, laudable – can be retained, but that their association with a supposed philosophical basis is disingenuous, misleading, and should be dropped.
Debates in Values-Based Practice is structured as a dialogic volume, so this and other chapters complement Prof. Bill Fulford‘s own account of values-based practice. The collection, which also includes his responses to the contributors’ commentaries, looks like a very rich, thought-provoking text for anyone interested in healthcare provision.