Philosophy Department, St. Catherine University, 2004 Randolph Ave, St. Paul, MN, 55105, USA.
Psychology Department, St. Catherine University, 2004 Randolph Ave, St. Paul, MN, 55105, USA.
Health Care Anal. 2019 Dec;27(4):289-308. doi: 10.1007/s10728-019-00367-9.
The term "effective," on its own, is honorific but vague. Interventions against serious mental illness may be "effective" at goals as diverse as reducing "apparent sadness" or providing housing. Underexamined use of "effective" and other success terms often obfuscates differences and incompatibilities in interventions, degrees of effectiveness, key omissions in effectiveness standards, and values involved in determining what counts as "effective." Yet vague use of such success terms is common in the research, clinical, and policy realms, with consequences that negatively affect the care offered to individuals experiencing serious mental illness. A pragmatist-oriented solution to these problems suggests that when people use success terms, they need to explain and defend the goals and supporting values embedded in the terms, asking and answering the questions, "Effective at what? For whom? How effective? And why that goal?" Practical and epistemic standards for effectiveness will likely remain plural for good reasons, but each standard should be well explained and well justified.
“有效”一词本身是带有敬意但却模糊的。针对严重精神疾病的干预措施可能在减少“明显的悲伤”或提供住房等目标上“有效”。对“有效”和其他成功术语的使用不足，往往会使干预措施、有效性程度、有效性标准中的关键遗漏以及确定什么算作“有效”所涉及的价值观之间的差异和不兼容性变得模糊不清。然而，这种成功术语的模糊使用在研究、临床和政策领域中很常见，其后果会对经历严重精神疾病的个人所获得的护理产生负面影响。一个面向实用主义的解决方案建议，当人们使用成功术语时，他们需要解释和捍卫这些术语所嵌入的目标和支持价值观，提出并回答以下问题：“在什么方面有效？对谁有效？效果如何？以及为什么是那个目标？”出于很好的原因，有效性的实用和认识标准可能仍然是多元化的，但每个标准都应该得到很好的解释和证明。
