Human Value Development

In his book, The Closing of the American Mind, Allan Bloom proposes that students entering the university may come from the left or right in regard to political views but will almost always share the position that truth is relative. This proposition is based on an accommodation to a pluralistic culture. History is viewed as a past in which men thought that they possess the truth, and even witch burning. The point that these students take from this reading of history is that the “true believer” is a dangerous person, and that only as we are able to avoid thinking that ours is the one right way can we survive. Openness and tolerance have become for these students the only plausible stance in the face of various claims to truth and an appropriate lifestyle. With this belief in relativism, the rational person then would not be concerned with correcting the mistakes from the past but rather would decide that all truth is relative and one view is equal to all other views.

In some sense, Massey subscribes to ethical relativism, a view that holds that there are no universal or absolute principles that bind human beings, and that the standards of right and wrong are always relative to the society or culture. In this light, the rightness or wrongness of customs or traditions that allow the placing of the aged on an ice floe to die, or the obligation of the brother to marry his dead brothers widow, could only be examined in reference to the Arctic Eskimo or African cultures from which they spring. The relativist would hold that there is no basis for saying that a particular act is right or wrong, independent of its cultural framework. Whatever we might believe in regard to relativism, and the lack of perfect truth, it would still seem reasonable that if we were in a position to do so, we would stop cannibals from eating missionaries and families from burning windows.

Few health care practitioners would be comfortable in taking a relativistic view of values. The decisions we must make are of such significance that the flip of a coin will not do. Some answers truly are better than others, and some decisions must not be made. To take an amoral position that somehow all answers to moral questions are equal would be unacceptable in health care practice. The philosopher Nietzsche was correct in his declaration that we are valuing animals. However, in regard to our values, humans are not programmed, as is the beast off the forest, to a proscribed set of correct actions but are condemned to lives of freedom and choice. In the practice of health care a position of “anything goes” is unacceptable. John  Steinbeck, in his book Of Mice and Men, pointed out how bankrupt we had become in regard to moral values when one of his characters commented, “There’s nothing wrong anymore”.

Modern health care is culturally overflowing with  value choices that must be made, and the choices we make will determine to great extent the shape of our careers and the pleasure we derive from the services we perform. There is a tradition of practice whereby health care providers will not conduct themselves in an egoist manner, but will consider the needs of the patients and the profession. Our patients are filled with expectations that we will perform in an ethical manner, even if it is unclear to them and us exactly what that entails.

Value theorists, such as Lawrence Kohlberg, Jean Piaget, and Carol  Gilligan have investigated the development of these worldviews and have provided models that show maturation and acquisition of value orientation throughout our childhood. The highest level of maturation described by Kohlberg and Piaget seems to be an autonomous decision-making system based upon legalistic equality. In recent years, Carol Gilligan has provided a feminist perspective and argues for separate developmental pathways for men and women , with the highest value for women being personal responsibility.


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