Genetics in the medical and psychosocial practice: on the role of value hierarchies in counselling

Abstract

Aim Values and value hierarchies play an important role in different health and counselling settings. Since personal values underlie our actions, guide our decisions and influence interactions, they can be assumed to influence doctor-patient relationships and therefore especially counselling situations. The aim of our study is to provide a sound empirical contribution to the increasing literature on values in health care settings. Subject and methods This article focusses on the personal values of professional groups involved in the medical and psychosocial care of patients or clients with genetic concerns. Results from 120 survey respondents who completed the Schwartz value survey reveal differences between the professional groups in their value hierarchies. Results There is a widespread, pan-cultural similarity regarding value hierarchies. Our results are in accordance with this universal hierarchy but show slight differences between the professional groups of the sample: Medical professionals ranked achievement and power values significantly higher. Psychosocial professionals, on the other hand, ranked universalism and hedonism values significantly higher than medical professionals. Conclusion Values motivate actions and serve as standards to evaluate them. As they can be presumed to influence the doctor-patient relationship and health care decisions, it is worth discussing differences in values and value hierarchies. Particular attention to that topic might be of interest for training and further education.

A Qualitative Look into Israeli Genetic Experts’ Insights Regarding Culturally Competent Genetic Counseling and Recommendations for Its Enhancement

“…In addition to the counselee's cultural background and values, the cultural context of the genetic expert also affects the delivery of culturally competent counselling. In health care, and especially in counselling settings, the values of patients and professionals are equally important or influential (Gschmeidler et al 2016). Value conflicts between counselor and counselee have been connected to different stressful situations on the counselors' side, when family decisions did not meet the counselors' values, leading at times to negative emotions in the counselor, such as guilt, helplessness, anger, or inadequacy (Bernhardt et al 2010).…”

“…One of the fundamental requirements for addressing the counselee in a culturally competent way is that the counselors have knowledge of the basic ethno-cultural values of patients and their families, since values motivate actions and serve as standards to evaluate them (Gschmeidler et al 2016). This can guide healthcare providers, like genetic experts, in delivering ethno-culturally competent, culturally sensitive genomic healthcare that meets the needs of a rapidly growing diverse population (Middleton et al 2007;Paniagua and Taylor 2008).…”

Towards Culturally Sensitive Shared Decision-Making in Oncology A Study Protocol Integrating Bioethical Qualitative Research on Shared Decision-Making Among Ethnic Minorities With Ethical Reflection

“…We will use Schwartz’s theory of basic human values to study the values underlying SDM and of the actors involved in SDM. Schwartz’s value theory has previously been used in studies on medical decision-making for both the investigation of patients’ (Aavik et al, 2014; Karimi & Clark, 2016) and HCPs’ values (Gschmeidler et al, 2016; Hermann et al, 2015; Moyo et al, 2016). The theory has been revised by Moyo et al (2016) into more fitting personal and professional values for HCPs (Moyo et al, 2016).…”