Case study 3.1

If you had to make the decision what personal values would influence your decision about Charlie? How do these conflict with professional values around best interests for Charlie?

This is just one example of complex decision making in healthcare. The clinical team and the parents, in deciding what to do regarding treatment, appeared to share the values of respect and best interests but the meaning was understood very differently from the clinicians/parent’s perspectives. What then ensued was the apparent conflict in values between Charlie’s parents who wanted to prolong Charlie’s life and the hospital’s decision, supported by research evidence and Charlie’s best interest, stressed on the issue of the potential complex question of Charlie’s quality of life if his life was prolonged.

Values based practice utilises a framework for practice which include four key clinical skills: awareness, reasoning, knowledge and communication skills. These are summarised in Table 3.1.