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external morality suggests a clear link between the values imparted in a professional context and their influence within that environment. There is evidence which supports this thesis. Andre (1992) suggests that during medical training student doctors reconstruct their view of the world so that patients become merely bodies. Andre refers to research demonstrating that students become conditioned to leave behind emotional responses to suffering and pain, and grow more cynical, less humanitarian, and more contemptuous of patients (1992, p. 148). The values that medical culture and education imparts to students are influential in their medical practice. Research also demonstrates that medical and institutional cultures may be influential on decision making. For example, physicians are more likely to withdraw therapy from supporting organs which have failed through natural rather than iatrogenic reasons (Christakis & Asch, 1993). Or put another way, if you have sustained some kind of disease or injury as a result of care or treatment given to you for treatment of your original medical complaint, you are more likely to be actively treated than if you presented with the same complaint from natural causes. Escher, Perneger and Chevrolet (2004) established that doctors’ decisions to admit patients to intensive care may be influenced by patients’ personalities or the availability of hospital beds. These examples demonstrate how values imparted from medical culture and health care institutions influence treatment decisions. The complete picture So far in this chapter I have considered a variety of potential mechanisms influencing the instrumentality of values in decision making; the passions, biological responses, cultures, society, and professional contexts. To consider any one of these explanations for the instrumentality of values in isolation is insufficient. Return to the very basic visual representation of decision making depicted in the introductory chapter. The depiction of reasoning developed earlier in this chapter has now established a far more complex picture of the instrumentality of values in decision making. When all of the explanations are integrated, a multi-layered representation of decision processes is constructed. Consider the following more thorough representation. 34
Societies and cultures Biological functions Value Evidence Value Evidence Value Evidence Value Evidence Value Passions, emotions and feelings Situation or question Decision outcome Figure 2. The complex values + evidence model of reasoning Professional cultures and institutions Life experience Of course, a visual representation of decision making can never fully represent the intricacy and complexity of human reasoning. At any one moment our senses are bombarded with evidence, our mind processes the evidence and our values work to guide and inform our reasoning. But what is demonstrated is the integral and multifaceted role of values in decision making. 35
Page 1 and 2: A Philosophical Critique of the Bes
Page 3 and 4: Legal principle ...................
Page 5 and 6: Legal process .....................
Page 7 and 8: Attestation of Authorship “I here
Page 9 and 10: Dedication To all the people who ha
Page 11 and 12: Introduction This thesis is a philo
Page 13 and 14: • Detention of an adult with auti
Page 15 and 16: compatible donor. Y appeared to be
Page 17 and 18: grounds. The value judgements which
Page 19 and 20: Cases concerning sterilisation of w
Page 21 and 22: esearch, Mercer identified the bias
Page 23 and 24: the judge conclude that the applica
Page 25 and 26: Chapter 1 - The objectivist myth Th
Page 27 and 28: purely empirically and scientifical
Page 29 and 30: of values-based law is based on the
Page 31 and 32: knowledge, and suggests that if kno
Page 33 and 34: Aren’t some values fundamental? A
Page 35 and 36: economics and sociology. A differen
Page 37 and 38: Some of Damasio’s everyday exampl
Page 39 and 40: longer do so? Or because he has no-
Page 41 and 42: Hume’s psychology of the passions
Page 43: authority is refuted by Kohlberg’
Page 47 and 48: cases by means of precedent; “by
Page 49 and 50: throughout the world. Sir Meadow ac
Page 51 and 52: paradigm, legal methods are employe
Page 53 and 54: Precedent It has been argued that w
Page 55 and 56: eading the same newspapers and watc
Page 57 and 58: Dworkin’s response appears to be
Page 59 and 60: that the behaviour has detrimental
Page 61 and 62: means, for example, that people are
Page 63 and 64: Kant’s philosophy is uncompromisi
Page 65 and 66: know the victim is your son. Kant
Page 67 and 68: greatest number. Faced with the ver
Page 69 and 70: eal life decisions is impossible wi
Page 71 and 72: Chapter 2 - Values-based Law There
Page 73 and 74: ules which is decisive on every iss
Page 75 and 76: the social world that we live in. C
Page 77 and 78: Consider another incident in Lord o
Page 79 and 80: 35). However, as I have tried to sh
Page 81 and 82: Part Two - The State of Nature The
Page 83 and 84: maintaining the fire. The fire goes
Page 85 and 86: the boys, they discard their identi
Page 87 and 88: Locke, 2002, p. 3 Accordingly, natu
Page 89 and 90: Stage three is the state of nature.
Page 91 and 92: Describing the background to his no
Page 93 and 94: longer calmer periods - which he ca
Page 95 and 96:
As time distanced the boys from the
Page 97 and 98:
In response to the new paradigm, th
Page 99 and 100:
The public debate facilitates the e
Page 101 and 102:
Consider the enactment of English p
Page 103 and 104:
sun. And so on. We do not say, at t
Page 105 and 106:
Theoretical methods for fixing laws
Page 107 and 108:
Consider the recent enactment of th
Page 109 and 110:
Chapter 3 - Bad Faith Values-based
Page 111 and 112:
In Being and Nothingness Sartre int
Page 113 and 114:
What makes bad faith bad? If we per
Page 115 and 116:
How can we believe by bad faith in
Page 117 and 118:
Good faith A further implication of
Page 119 and 120:
mother.” (Warnock, 1978, p. 117).
Page 121 and 122:
The Milgram experiments and bad fai
Page 123 and 124:
The agentic state From his findings
Page 125 and 126:
Self-deception For Sartre, self-dec
Page 127 and 128:
to continue to follow the orders of
Page 129 and 130:
state in which soldiers become inst
Page 131 and 132:
emain unanswered and important aspe
Page 133 and 134:
Conscious awareness However success
Page 135 and 136:
Objectification. Intention Deceptio
Page 137 and 138:
Case study 2 - the American soldier
Page 139 and 140:
of this kind, unfathomable situatio
Page 141 and 142:
Good faith Gillman’s research dem
Page 143 and 144:
the question at hand. The question
Page 145 and 146:
opportunities for discussion and de
Page 147 and 148:
situations we meet in our every day
Page 149 and 150:
I contend that because we seek cert
Page 151 and 152:
For years, health professionals hav
Page 153 and 154:
The sterilisation was regarded as u
Page 155 and 156:
the sterilisation procedure would b
Page 157 and 158:
Decision making is further inhibite
Page 159 and 160:
subjectivity and denying the inesca
Page 161 and 162:
uncertainty about the provision of
Page 163 and 164:
In 3 instances 12 it was establishe
Page 165 and 166:
childbirth, child-rearing, and that
Page 167 and 168:
More recent research supports Saber
Page 169 and 170:
doctor reported that C “did under
Page 171 and 172:
assertion that traditional societie
Page 173 and 174:
Re M appears to be the only case in
Page 175 and 176:
irregular periods. The mother descr
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hysterectomy for a 29 year old woma
Page 179 and 180:
Three cases adopted a predominantly
Page 181 and 182:
A cluster of cases from Australia f
Page 183 and 184:
equires a ceasarian section deliver
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(1) In determining for the purposes
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clinical judgement values are objec
Page 189 and 190:
Conclusion and recommendations An a
Page 191 and 192:
allocation of scarce health resourc
Page 193 and 194:
Values transparency in best interes
Page 195 and 196:
What if… judges were able to expl
Page 197 and 198:
Epilogue I write this epilogue in r
Page 199 and 200:
of high quality research’ at the
Page 201 and 202:
Visualising our personal values on
Page 203 and 204:
Rational fields Rational fields and
Page 205 and 206:
Type 5: ‘Filing reality - classif
Page 207 and 208:
Within the rational field is not on
Page 209 and 210:
conclusion about value, about what
Page 211 and 212:
A similar picture emerges from the
Page 213 and 214:
The present appeal raises moral, le
Page 215 and 216:
expressing differing emotional resp
Page 217 and 218:
Environment Doctor knows best Relat
Page 219 and 220:
Statute The Code of Health and Disa
Page 221 and 222:
Re S (Medical Treatment; Adult Ster
Page 223 and 224:
Biegler, P. (2002). Should patients
Page 225 and 226:
Eastman, N., & Peay, J. (1999). Law
Page 227 and 228:
Henaghan, M. (2002). Human rights a
Page 229 and 230:
Laurie, G. T., & Mason, J. K. (2000
Page 231 and 232:
Myser, C. (1994). A philolosophical
Page 233 and 234:
Singer, P. (2001). Writings on an E
Page 235 and 236:
Case reference Re H [1993] NZFLR LE
Page 237 and 238:
Re S (Medical Treatment; Adult Ster
Page 239 and 240:
In re B (A Minor) Wardship: Sterili
Page 241 and 242:
Case reference Re X (Sterilisation:
Page 243 and 244:
Re Marion (No 2) [1992] 17 FamLR Au
Page 245 and 246:
Re S (Adult Patient: Sterilisation)
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