Values that Fit: Guidance for Adopting Entangled Values in Medicine that Goes Beyond “Illegitimate and Legitimate”


Sarah Wieten


I argue that we can improve on previous attempts to differentiate appropriate and inappropriate values for a scientific project. My paper proceeds in four sections. First, I critique the legitimate/illegitimate distinctions based on the two line drawing metrics suggested in the literature: epistemic content and the completeness of the non-value involved evidence (the “lexical-priority” metric). I argue that both these distinction drawing metrics fail to be universally applicable across all sciences, and fail to assist in practical distinction drawing. In a larger second section I argue for transparent, local, and context-based value adoption in particular sciences and provide an example case for use in statins medical research. In a brief third section I entertain possible counter-arguments to my account of transparent, local and context-based value adoption including worries about relativism and the “entrance” of politics into science. Lastly I consider what implications this more complicated picture of values in medicine requires; if what must be done is more than asking “Is this value legitimate based on metric X?” this will require more training, more communication and transparency, more philosophical involvement and more forums for debate and discussion about adopted values both in clinical practice and in medical research.