Values, foundations and being human

Abstract

The word 'values' is widely used, and it is usually assumed that everyone knows what you mean when you use it. It refers to certain commitments to which you hold, certain attributes that guide behaviour and underpin your judgements. Your values are important, and when you are asked to do something that contradicts those values, you feel uneasy. You may make a stand, refuse to act, or you may act in ways that are personally inconvenient, threatening or risky in order to stick to your values, to be consistent with their demands. That seems simple enough, but there are already some uncertainties. How do values, construed in these terms, differ from virtues or altruism or ethical behaviour? Does the branch of philosophy called axiology have anything more to say about our judgements than ethics and aesthetics reveal? Why has axiology waxed and waned in fashion and importance over the years? Is there any value for the philosophy or practice of medicine in exploring axiology? I think there is, and in this chapter I want to explore four things: (1) a particular view of values as 'first philosophy' of social organisation and interaction; (2) a formulation of foundationalism that is descriptive and pre-normative, rather than prescriptive and normative; (3) a way to understand health care as grounded in foundational values that are expressed in different ways in different cultures and societies; and (4) an explanation of the potential contributions that a values-based medicine of this kind might make to medical philosophy, practice, policy and education.