"What the patient wants': an investigation of the methods of ascertaining patient values in evidence-based medicine and values-based practice

作者：Wieten Sarah^*

来源：Journal of Evaluation in Clinical Practice, 2018, 24(1): 8-12.

DOI：10.1111/jep.12471

• evidence-based medicine
• Fulford
• Greenhalgh
• patient-centred care
• person-centred care
• value-based practice

Evidence-Based Medicine (EBM), Values-Based Practice (VBP) and Person-Centered Healthcare (PCH) are all concerned with the values in play in the clinical encounter. However, these recent movements are not in agreement about how to discover these relevant values. In some parts of EBM textbooks, the prescribed method for discovering values is through social science research on the average values in a particular population. VBP by contrast always investigates the individually held values of the different stakeholders in the particular clinical encounter, although the account has some other difficulties. I argue that although average values for populations might be very useful in informing questions of resource distribution and policy making, their use cannot replace the individual solicitation of patient (and other stakeholder) values in the clinical encounter. Because of the inconsistency of the EBM stance on values, the incompatibility of some versions of the EBM treatment of values with PCH, and EBM's attempt to transplant research methods from science into the realm of values, I must recommend the use of the VBP account of values discovery.

• 出版日期2018-2