Values and ethics in practice-based decision making

Background. Values are evident in health ethics literature; however, it is seldom clear how they are visible in practice. Purpose. The aim of this study was to illuminate how values inform occupational therapists' decision making in practice. Method. Fifteen New Zealand community occupational therapists completed this embedded experimental mixed-methods study. A pre-deliberation questionnaire was completed prior to deliberation of a case study using web-based values transparency software, the Values Exchange, followed by a post-deliberation questionnaire. Categorical data were analyzed using non-parametric statistics. Written responses to open questions were thematically analyzed. Findings. Most participants disagreed with the proposed action for the case. Degrees of divergence, concern for dignity and risk, and values-based reasoning were found, revealing how ethical deliberation was values based. Implications. Recognition and transparency of the values inherent in practice-based decision making is possible and desirable in promoting sound ethical reasoning.