Alexopoulos Panagiotis, Leroi Iracema, Kinchin Irina, Canty Alison J, Dasgupta Jayashree, Furlano Joyla A, Haas Aline Nogueira
Mental Health Services, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece.
Global Brain Health Institute, Trinity College Dublin, D02 X9W9 Dublin, Ireland.
Brain Sci. 2024 Jul 17;14(7):718. doi: 10.3390/brainsci14070718.
Brain health is a complex concept, shaped by a plethora of determinants related to physical health, healthy environments, safety and security, learning and social connection, as well as access to quality healthcare services. Decision-making in this complex field is characterized by diverse values, potentially conflicting interests, and asymmetrically influential stakeholders. Values-based practice (VBP) is a toolkit for balancing values in a democratic and inclusive way, so that every stakeholder feels a sense of ownership over the decision made. In VBP, the emphasis is on good process rather than on pre-determined 'correct' outcomes. Based on two case vignettes, we highlight the relevance of the ten principles of VBP for balancing different values to the satisfaction of those directly concerned, in a given decision-making process. In addition, we argue that the successful implementation of VBP in the complex area of brain health, as well as in other fields, is premised on higher order values (meta-values), beyond mutual respect and the legal, regulatory, and bioethical framework. These include mutual regard, reciprocity, autonomy, and an egalitarian attitude towards VBP procedures and involved stakeholders.
脑健康是一个复杂的概念，受到众多与身体健康、健康环境、安全保障、学习与社会联系以及获得优质医疗服务相关的决定因素的影响。在这个复杂领域中的决策具有多样的价值观、潜在冲突的利益以及影响力不对称的利益相关者的特点。基于价值观的实践（VBP）是一种以民主和包容的方式平衡价值观的工具包，以便每个利益相关者对所做的决策都有主人翁意识。在基于价值观的实践中，重点在于良好的过程而非预先确定的“正确”结果。基于两个案例 vignettes，我们强调了基于价值观的实践的十条原则对于在特定决策过程中平衡不同价值观以满足直接相关方满意度的相关性。此外，我们认为，在脑健康这一复杂领域以及其他领域成功实施基于价值观的实践，是以超越相互尊重以及法律、监管和生物伦理框架的更高层次的价值观（元价值观）为前提的。这些包括相互关心、互惠、自主以及对基于价值观的实践程序和相关利益者的平等主义态度。
