Values-Based Practice

This chapter outlines the origins in ordinary language philosophy of a new skills-based approach to working with complex and conflicting values in medicine called values-based practice. Ordinary language philosophy (as exemplified by Austin and others of the mid-twentieth-century "Oxford school") focuses on our use of words as a (sometimes) useful first step in coming to a more complete understanding of their meanings. The theory of values-based practice was developed by applying ideas from ordinary language philosophy to the long-running debate about the "boundary problem" presented by the concept of mental disorder. Ordinary language philosophy turns this debate topsy-turvy: it shows, (a) that the concept of mental disorder instead of being the target problem is a resource for coming to a more complete understanding of the meanings of concepts of disorder as a whole including the concept of bodily disorder; and correspondingly, (b) that the value-laden nature of mental disorder far from being part of the problem (to be solved either by limitation or outright elimination) points to an evaluative element of meaning in concepts of disorder as a whole, again including concepts of bodily disorder. It is these topsy-turvy results that underpin the development of values-based practice. In a brief concluding section we indicate the potential for further development of values-based practice supported by ordinary language and other philosophies particularly through engagement with non-Western language groups representing diverse traditions of thought and practice in mental health.