Chapter

Methods

Bill (KWM) Fulford, Katherine Morris, John Z Sadler and Giovanni Stanghellini

in Values and Psychiatric Diagnosis

Published on behalf of Oxford University Press

Published in print October 2004 | ISBN: 9780198526377
Published online March 2013 | e-ISBN: 9780191754357 | DOI: http://dx.doi.org/10.1093/med/9780198526377.003.0002

Series: International Perspectives in Philosophy & Psychiatry

Methods

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Let me briefly summarize this long chapter. I have already clarified that values in classification range from the controversial and nonconsensual to the mutual and consensual. In the following section I adapt Kuhn’s work on understanding scientists’ theory-choice to flesh out at least one internal role that values might play in psychiatric classification. This material introduces the idea that values are intrinsic or built into scientific rationality, and not merely limited to how scientific findings are applied or used. In the following section on values, value-terms, and value-semantics, I discuss some of the logical and practical features of evaluative talk that will help us identify value-laden meanings in the ‘discourse’ of psychiatric classification and its related literature. These logical and practical features of values lead to a discussion of the descriptive kinds of values that might appear in discussions of nosology (Five heuristic types of value). These logical, practical, and descriptive characteristics of values are then illustrated with four short (and perhaps deceptively simple) examples of literature discussions on psychiatric classification. Throughout my discussions, I have used endnotes to elaborate more philosophical considerations, provide more concrete examples and cite the relevant literature, but reading the endnotes is not essential to grasping the whole.

Returning now to the issue of the relative congruity of values underlying the DSM and ICD architects’ work, how might we understand such agreement? The diagnostic manuals rarely, if ever, refer to ‘values’ in their development, but often mention ‘goals’ or ‘objectives’ that guide the participants’ actions. Moreover, published information about the development and discussions of the goals is quite limited and general,9 so we are left with educated guesses about how they were developed. Further, as we discuss the development of various diagnostic systems in this century, we will find a significant amount of change in guiding principles. We seem to have a paradox: the psychiatric nosologists seem to develop a significant degree of consensus about what they want in a diagnostic system, yet substantial changes occur over the years — even dramatic ones. How does this occur? What forces shape the changes?

Chapter.  15256 words. 

Subjects: Psychiatry

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