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

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.