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

VALUES CLARIFICATION

Values change over time in response to changing life experiences. Recognizing these changes and understanding how they affect one's actions and behaviors is the goal of the values clarification process. Values clarification will not tell you what your values should be, it simply provides the means to discover what your values are.

For the purpose of values clarification, Raths, Harmin and Simon identified seven criteria that must be met if a value is to be considered a full value. These criteria can be divided into three categories: choosing, prizing and acting16. To be a full value, the value must be chosen freely from a list of alternatives, only after thoughtful consideration has been given to the consequences of each alternative. The value must be cherished and made known to other people. The value must also be translated into behaviors that are consistent with the chosen value and integrated into the life style.

CRITERIA FOR A FULL VALUE

The following series of questions and case studies are designed to help you examine your thoughts and feelings about various aspects of genetic counseling and prenatal diagnosis. These questions are adapted from the text, "Values Clarification in Nursing," 2nd Edition, by Steele and Harmon17.

Indicate your degree of agreement or disagreement with the following statements by placing the number that most closely indicates your value next to each statement.

1. Strongly Agree 2. Agree 3. Ambivalent 4. Disagree 5. Strongly Disagree

_____ Abortion decisions are the responsibility of the pregnant woman and her physician.

_____ Genetic screening should be offered to all at-risk people.

_____ Amniocentesis should be required as part of prenatal care.

_____ Artificial insemination should be available to anyone who seeks it.

_____ A person who has a genetically transmitted disease should be encouraged to have amniocentesis.

_____ Infants born with severe defects should be allowed to die through the natural course of the disease.

_____ Individuals who carry abnormal genes should not have children.

_____ Women who find out they are carrying a fetus with a serious birth defect or genetic condition should be required to terminate the pregnancy.

_____ Couples who knowingly choose to have a child with a birth defect should be financially responsible for all of the child's health care and educational needs.

CASE STUDIES

Mr. Smith's father had Huntington disease. He was diagnosed at age 40 after losing his job and leaving his family. Mr. Smith is 28 years old and through presymptomatic testing knows that he carries the gene coding for this disorder. He has come in to talk about his future family plans. What would you choose to do if you were in his shoes? If he makes a different choice than the choice you have made, how do you think this might affect your interactions with him?

A young couple with three children learn that their unborn child has trisomy 18. Do you think that your professional relationship with this couple would change if they chose to terminate the pregnancy? How would you feel towards this couple if they chose to have this child and insisted on doing everything possible to keep the baby alive?

A young couple has two children with sickle cell anemia who are on Title 19. They are not using any form of birth control as they would like to have more children. Would their choice affect your feelings towards this couple or your ability to work with them or their children?

SUMMARY

There are no right or wrong responses to the above questions. Rather, this exercise is designed to help you identify your values and examine the relative importance of these values in your personal and professional life.

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