HEALTH AND VALUES - THE VALUES UNDERLYING HEALTH MEASUREMENT AND HEALTH RESOURCE

There are several meanings of health outcome: the gap between attainme nt and aspiration, the objective level of attainment, and the capacity to adapt to changed circumstances, and each of these different meanin gs reflect different value systems about the meaning of life. Existing health measuring scales reflect one particular type of value system - that health status is indicated by level of health complaint. Health measurement is inevitably value dependent. Health measuring scales are used in deciding how to allocate scarce health resources within healt h care systems, and this process of resource allocation involves addit ional value judgements, value judgements which should be made explicit . Current health resource allocation decisions reflect a model of medi cine where individual differences in response to treatment are discoun ted. The biopsychosocial model is consistent with the suggestion that individual differences in response to treatment and individual differe nces in valuation of outcome should be expected, predicted, and should be taken into account in resource allocation.