Seminar: Professor Bill Fulford, "Combining Values-Based Practice with Evidence-Based Practice in Psychiatric Diagnosis"

Past Event

21 January 2009, 4:00pm - 6:00pm

Lecture Theatre, Oxford Martin School
34 Broad Street (corner of Holywell and Catte Streets), Oxford, OX1 3BD

Professor KWM (Bill) Fulford, Department of Philosophy, Universities of Warwick, Oxford, and Central Lancashire; Department of Health, UK

Abstract: As in other areas of medicine, it has been widely assumed that while values may be important in the treatment of mental disorder, diagnosis is a matter exclusively for value-free science. This lecture will use a case history to show, to the contrary, that values come into the diagnosis of mental disorder right at the heart of psychiatry’s most scientifically–grounded classification, the American Psychiatric Association’s DSM. Three different interpretations of the importance of values in psychiatric diagnosis will be outlined: one that excludes science, one that excludes values, and a third interpretation (based on work in the Oxford Analytic tradition of philosophy) that brings values and science fully together. This third interpretation opens up psychiatric diagnostic assessment to the resources of a new skills-based approach to working with complex and conflicting values called “values-based practice”. The principles of values-based practice will be briefly introduced and then illustrated with a number of recent developments in policy and service development in the UK’s Department of Health and internationally. In particular the results of a current Department of Health programme on best practice in diagnostic assessment will be described. This programme, which is being run jointly by Bill Fulford with the service user and carer leads for the Department of Health, respectively Laurie Bryant and Lu Duhig, illustrates how person-centred diagnostic assessment depends crucially on combining scientific evidence with individual human values rather than excluding either. The lecture will conclude with an indication of how psychiatry is leading medicine as a whole in combining values-based with evidence-based approaches to clinical decision-making.