(Lesson 4- Table of Contents) (Next) (Glossary)

Values determine behaviors or modes of conduct. Once a value is internalized it becomes, either consciously or unconsciously, a standard for guiding actions and making choices. Because values are at the basis of choice, the choices people make reflect their perception of what is right, just or cherished at a particular time.

We all have a number of personal and professional values. In certain situations, it may become apparent that some of these values are in conflict. For example, a health care provider may value life. He/she may also value the alleviation of pain. As a rule, these are not conflicting values. However, when working with a terminally ill patient a conflict may arise. By providing intravenous fluids, the patient's life is sustained but pain is prolonged rather than alleviated.

When individuals are challenged and their values conflict, they may find it necessary to re-examine their values. Through this reassessment process people may acknowledge that, under certain circumstances, it is possible to hold values that are inconsistent with one another. For example, health care providers are unlikely to come to the conclusion that they should stop valuing life or the relief of pain based on their interactions with a terminally ill patient.

In other circumstances, challenging situations may arise that will lead people to conclude that their values have changed. Early in their careers, health care providers who value life may do everything humanly possible to prolong a person's life. Over time, however, their experiences may lead to a subtle shift in their values. If they begin to value the quality of life, rather than life as mere existence, there may be a change in their interactions with and feelings towards terminally ill patients. They may no longer experience the emotional struggle they once did when the decision is made not to resuscitate a patient.

When personal and professional values are inconsistent with one another, the expression of the professional role may be jeopardized and feelings of discomfort or frustration are likely to emerge. Such inconsistencies may occur if a health care provider's religious beliefs conflict with professional responsibilities. For instance, if a health care provider believes that abortion is morally wrong, it may be difficult to care for a patient who chooses to have an abortion. In such cases the decision not to work with a patient who is terminating a pregnancy is made based on the relative importance of these two values (i.e., adherence to religious beliefs and patient autonomy in decision making) in the health care provider's hierarchy of values.

(Lesson 4- Table of Contents) (Next) (Glossary)