Values in the choice of treatment: replication and refinement

Area of Science:

• Medical Ethics
• Psychology
• Health Services Research

Background:

• The Gortner Values in the Choice of Treatment Inventory assesses moral principles in healthcare.
• It is based on autonomy and beneficence/nonmaleficence, foundational ethical principles.
• Previous use was with cardiac surgery patients and their spouses.

Purpose of the Study:

• To replicate the Gortner Values in the Choice of Treatment Inventory with a new sample of cardiac surgery patients and spouses.
• To examine patient-spouse agreement on moral values influencing treatment choices.
• To analyze value preferences between autonomy and beneficence/nonmaleficence.

Main Methods:

• Replication of the Gortner Values in the Choice of Treatment Inventory.
• Patient-spouse correlation analysis for Autonomy and Beneficence/Nonmaleficence scales.
• Repeated measures analysis of variance using family scores (patient-spouse mean).
• Factor analysis on combined samples for refinement.

Main Results:

• Significant patient-spouse correlations were found for Autonomy (r = .26, p = .03) and Beneficence/Nonmaleficence (r = .38, p = .002).
• A significant preference for Autonomy over Beneficence/Nonmaleficence was observed (p = .001).
• A refined 12-item, two-factor solution demonstrated a common factor and scoring applicable to both family and patient data.

Conclusions:

• The Gortner Values in the Choice of Treatment Inventory demonstrates patient-spouse agreement on core ethical values in cardiac surgery contexts.
• Autonomy is a more highly valued principle than beneficence/nonmaleficence in treatment decision-making for these patients.
• A validated 12-item instrument provides a reliable measure for assessing these values in patients and families.