Construction of Values

Definition

Preferences about goods, health states, or even issues are thought to exist on a continuum, from those that are basic to those that are highly complex. Basic values are easily known and expressed by an individual; these values are quite possibly innate. Complex values require extensive cognitive effort to understand and express and may not be immediately available to an individual. For example, an infant's preference for its mother over another person could be considered a basic, innate preference or value. Similarly, the value one person places on Pepsi versus Coke is basic and known and easy to express. At the other extreme, the value placed on a painful and debilitating yet life-extending therapy might not be known to an individual without the benefit of extensive thought, consideration, and deliberation. The value for this therapy is based on more basic values but is some combination of many considerations and preferences, including trade-offs among conflicting values, resulting in a complex preference. The construction of values refers to this latter process in which an individual uses information and more basic values to construct, or build, the more complex value.

Construction Process

Values are constructed at the time when an individual is faced with a situation that demands knowledge or expression of his or her values. In general, values are called on every time an individual makes a choice or decision, from purchasing one brand versus another to casting a ballot. In the context of health and medicine, values are usually called on when an individual is faced with a decision about a medical intervention or treatment, from something as simple as receiving a flu shot to consenting to surgery. Values are also invoked during surveys and experiments asking about choices and decisions, wherein much of our knowledge about preference construction has been demonstrated.

The construction process generally begins when an individual is faced with a choice or decision that defies basic values. For example, if a person is asked which political party he or she supports, he or she may reply “Democrat” or “Republican.” If a person is asked whether she supports Candidate A or Candidate B, she may ask about the candidates' positions on an issue important to her, such as environmental protection. On learning of the candidates' positions, she will choose A or B. If then she is told Candidate A is female and Candidate B is male, and this person prefers to support a female candidate, she will have to consider both the candidates' genders and their positions on environmental protection to make a choice. If the male candidate is a stronger proponent of environmental protection, the person has to weigh the importance of her gender preference against her environmental protection preference to arrive at a decision. This type of choice would be considered to invoke complex values because it is not readily apparent what choice would be dictated from the basic values regarding gender and environmental protection. Values for the candidates hence would be constructed from the information and basic values. Value construction occurs when basic values would suffice but information is unknown, when basic values do not exist for the options encountered, or when the complexity of the choice involves combinations of or trade-offs among basic values.

...