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Risk, Safety and Clinical PracticeHealth care through the lens of risk$
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Bob Heyman, Andy Alaszewski, Monica Shaw, and Mike Titterton

Print publication date: 2009

Print ISBN-13: 9780198569008

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780198569008.001.0001

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Values and health risks

Values and health risks

(p.59) Chapter 3 Values and health risks
Risk, Safety and Clinical Practice

Bob Heyman

Oxford University Press

This chapter starts from the observation that a sense of adversity is bound into modern risk-thinking. Evoking risk conveys to the contemporary mind that a negatively valued outcome is causing concern. However, because risk-taking entails multiple consequences, undesired outcomes must also be balanced against potential gains. The ideas of positive risk-taking and autonomy/safety balancing are discussed in relation to the recognition of multiple consequences. It is then argued that the standard notion of an ‘adverse event’ misleadingly projects acts of valuing onto outcomes, directing attention away from potential differences of perspective. This issue is explored through a critique of quantitative approaches to expected value, such as the calculation of quality-adjusted life years (QALYs). The final part of the chapter reviews social scientific explanations for organized risk selection, addressing the question of why societies and social groups might focus on certain risks whilst ignoring or neglecting others.

Keywords:   adverse events, expected value, multiple values, QALYs, risk selection, valuing

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