Eliciting Values In Health Services Research: Philosophies, Disciplines And Paradigms

The Centre for Health Program Evaluation (CHPE) is a research and teaching organisation established in 1990 to: • undertake academic and applied research into health programs, health systems and current policy issues; • develop appropriate evaluation methodologies; and • promote the teaching of health economics and health program evaluation, in order to increase the supply of trained specialists and to improve the level of understanding in the health community. The two units undertake their own individual work programs as well as collaborative research and teaching activities. PUBLICATIONS The views expressed in Centre publications are those of the author(s) and do not necessarily reflect the views of the Centre or its sponsors. Readers of publications are encouraged to contact the author(s) with comments, criticisms and suggestions. A list of the Centre's papers is provided inside the back cover. Further information and copies of the papers may be obtained by contacting: Both units obtain supplementary funding through national competitive grants and contract research. The research described in this paper is made possible through the support of these bodies. ABSTRACT A central problem in applied social sciences is eliciting preferences and values from people. Such elicitations are carried out by researchers working from many base disciplines and these people bring to their tasks paradigms and methodologies embedded in those disciplines. Underlying these methodologies is a "continuum of philosophies "that describe belief systems and assumptions pertaining to the ability of respondents to formulate and express values. These lead to very different operationalised research designs and, frequently, different conclusions. This paper outlines these underlying philosophies and assumptions as they relate to four disciplines concerned with health services research-experimental cognitive psychology, survey research, decision analysis and economics. It is concluded that, for a variety of reasons, one should not hope too much for cross-disciplinary communication and fertilisation; nor that researchers will recognise the limitations of their own disciplines in applied research.