TERM PAPER

VALUE SPECTRUM

GROUP MEMBERS- ROLL NO.-

SOHAN DUTTA 29

ANUJ PRASAD 53

SHOUMOSHREE MONDOL 41

SASWATA BARAL 05

SOUMYAJIT CHAKRABORTY 17

窗体底端
VALUE SPECTRUM & GOOD LIFE
Value Spectrum of Good Life:
 Research has shown that, at best, we are only capable of recognizing and describing
20% of our values. The remaining 80% of our values are unconscious but ultimately
still drive our behavior.

At any one time we are living according to 10 – 15 very specific values. Because the
majority of our values are unconscious, individuals typically cannot identify, let alone
articulate their values.

Our attitudes, beliefs and values are dynamic, shifting and constantly being
reprioritized to cope with the changing relationship we have with the world around us.
The priority we assign to different values changes over time as we navigate our way
through life based on aging, experience, changes in environment and/or
circumstances. We rarely stay in one place for longer than 18 months and our values
change along an identifiable framework that we move along both forward and
backwards.

Good Life: A good life can be lead in a society with peace, harmony, well-being and
fellow feeling. Just like light has seven distinct spectrum colour expressed as
“VIBGYOR”, similarly a good life comprises of seven important values. They are

1. material values
2. social values
3. aesthetic values
4. physiological values
5. ethical values
6. spiritual values
7. ethical values
The above seven values are known as the spectrum of good life.

Good Life:

A good life can be lead in a society with peace, harmony, well-being and fellow
feeling. Just like light has seven distinct spectrum colour expressed as “VIBGYOR”,
similarly a good life comprises of seven important values. They are material values,
social values, aesthetic values, physiological values, ethical values and spiritual
values. The above seven values are known as the spectrum of good life.

Characteristic of Good Life:

 Creative thinking is one of the most prized endowments of human beings. It

helps people to think, to dream and to create visions of a good life, and the civilization
moves up from one tier to next higher tier. It is an on going process
 Every generation thinks dreams and finally articulate the ways and means to
better their life.
 Civilization after civilization has simply vanished from the earth, because they
became complacent and stopped dreaming.
 Simply thinking or dreaming do not guarantee ‘good life’ it wants, it has to
create conditions and capabilities to translate the dreams into reality
 There are difference in these dreams over different individuals , groups and
culture
 Some may be matter of details, some more fundamental.
 Yet there is a large quantum of commonality in the conceptions of values
which constitute a ‘good life’ [ example – the chariot wheel, bullock cart wheel,
Mercedes Benz]
Types of Values: Elements of Value Spectrum

Physiological/Material Values:

 Values associated with material aspect/comfort of living are called material

values.
Societal Values:

 Good life can be lived only in a good society

 Such society provides peace, harmony and general well-being with overall
growth
 This is necessary to ensure social cooperation for production of material and
social goods
 In a good society everyone is aware of their rights, earning a livelihood and
freedom to blossom to their potential
 Societal values refer to making a good society. They are operatives in social
structures and the basic social institutions created by society
 Larger concept which includes social capital as well as the subjective aspects
of the citizens’ well-being, such as their ability to participate in making decisions that
affect them.
 Justice
 on one hand it means people getting their rightful dues, reward, recognition,
respect for rights, liberties, meeting valid demands, on the other hand the area of law,
legal justice is a formal procedure followed by courts adjucating conflicting claims of
litigants.
 Rules of Law
 Democracy
 Secularism
Psychological Values:

 One must possess sound mental health, maturity for a good life.
 There should not be any stress, psychological conflicts. The value
determinants of a good life can be grouped into 2 categories.
 Internal – These values are concerned with the quality of emotional and
mental life of an individual. It is the attitudes and myriad of mental processes which
covers the world of our feelings, desires, impulses, motives and goals.
 They collectively shape our personality, external behavior and our sense of
well – being, happiness and harmony.
 Integrated Personality
Aesthetic Values:
 Creation and enjoyment of beauty are part of a good life. A careful cultivation
of taste for appreciating beauty in art, nature and life leads to bliss and is called
Aesthetic values.
 A good person must be a moral person, his personal conduct and social
interrelations must be based on ethical principles.
 Ethical and moral values occupies the centre stage in good life.
Perception:

Perceptions vary from person to person. Different people perceive different things
about the same situation. But more than that, we assign different meanings to what we
perceive. And the meanings might change for a certain person. One might change
one’s perspective or simply make things mean something else. It is a mental tool for
appreciation of beauty.

Spiritual Values:

The values of truth, righteousness, peace, love and non-violence are found in all major
spiritual paths. These spiritual values are also human values and are the fundamental
roots of a healthy, vibrant, and viable work career.

The following table contains a number of Spiritual Values:

Peace Joy Love

Forgiveness Compassion Faith
Hope Charity Happiness
Spreading Happiness Affection Serenity
Consideration Contentment Contribution
Helpfulness Honesty Humility
Impartiality Integrity Modesty
Kindness Patience Satisfaction
Self-actualization Simplicity Sincerity
Sympathy Thankfulness Tranquility
Truthfulness Understanding Warmth
Spiritual Values:
Material Values, Valued Possessions, and Their Use: A Study of Schoolchildren Age
Nine to Fifteen Hanna Hjalmarson, Stockholm School of Economics, Sweden
ABSTRACT This paper reports a study of material values, other values, and
possessions in young consumers. As in adults, according to definition, material values
in schoolchildren are associated with valuing more, and more expensive things. High-
materialism children also value publicly consumed and status-oriented things more
than lowmaterialism children. However, in contrast to adults, high-materialism
children do not value things associated with other people (e.g., photos) less than low-
materialism children. In all, they value interpersonal relations as much, or more, than
low-materialism children. In fact, many possessions high-materialism children value
more can be used in interpersonal relations, and are perhaps therefore valued.
INTRODUCTION Each and every year, we seem to buy more things. For example,
between 1956 and 1995, retail sales in Sweden doubled, measured in the prices of
1995, and since then, it has increased with yet another 30 percent (Jacobsson 2003).
Partly, this may be due to an increase of disposable income, but it can still be
considered puzzling, as both popular wisdom (cf. Fournier and Richins 1991) and
research findings (cf. Richins and Dawson 1992) tell us that more things (above a
certain necessity level) do not make us happier. Why is it, then, that so many people
still buy more and more? An assumption held by many, which has also been tested
empirically, is the idea that possessions say something about the owner’s personal
values (cf. Belk 1988; Richins 1994; RochbergHalton 1984; Simmel 1978; Veblen
[1899] 1953). When it comes to the number and nature of the possessions a person
considers important, material values, often partly defined in terms of the assumption
that more things make us happier (cf. Richins and Dawson 1992), ought to be
especially interesting. For an adult American sample, it has previously been found
that people high in material values tend to value more expensive, prestigious, and
publicly consumed possessions, that are moreover not explicitly related to significant
others (Richins 1994). It has also been found that people high in material values
consider interpersonal relations to be less important than those low in material values.
Also, they put more weight on financial security (Richins and Dawson 1992). In this
paper, I try to tie these findings together for a sample of Swedish schoolchildren age
nine to fifteen. The main reason for studying Swedish schoolchildren is practical–it
happens to be my dissertation area–but there may be other things that make them an
interesting group to study when it comes to material values, other values, and valued
possessions. Swedish children have been found to be the richest children in the world,
according to a Unicef study. In Sweden, only 2.6 percent of the families with children
could be defined as poor. The corresponding share for US children was 20 percent
(Aftonbladet, June 26 2000). Moreover, second only to British children, Swedish
children receive the most money in Europe (Datamonitor 2004). The possible effect
of this wealth on their material values is worth further study. Also, Swedish children
of course differ from American adults not only by their cultural setting, but also by
their age. Whereas adults are generally said to have developed an identity, where
material possessions can be part of the extended self (cf. Belk 1988), children are still
in the process of developing their identities. Actually, it appears that for children, the
relations between material values, other values, and valued possessions are not the
same as for adults (it should be noted that even though there were certain differences
between children of different ages in my data, they will not be elaborated on in this
paper, due to space limitations). MATERIAL VALUES AND VALUED
POSSESSIONS Material values have been defined as the tendency to place
possessions and their acquisition as central in one’s life, to view possessions as a
means to happiness, and as an indicator of own and others’ success (Richins and
Dawson 1992). People with strong material values are said to value things in
themselves, more than as means to other goals (Mukerji 1983). The possessions
people perceive as important in their lives often reflect their personal values (Richins
1994). Given that values are guiding the attitudes, judgments, and actions of the
individual (Rokeach 1973), the possessions he or she considers most important are
also likely to reflect his or her most important values (Prentice 1987). Richins (1994)
discusses two types of meaning that people can attach to physical objects: public and
private. As the labels suggest, public meanings are shared by society at large (e.g., a
golden necklace is an expensive piece of jewelry), whereas private meanings are
personal, although influenced by the public meanings, and also often connected to
friends or family (e.g., my great grandmother’s golden necklace is invaluable to me).
Richins proposes that high-materialism people place more importance on things that
(1) are consumed publicly, and (2) have the public meaning of being expensive, thus
denoting wealth and success (Fournier and Richins 1991; Richins 1994). Because
material values and interpersonal values are often perceived as opposite dimensions
(cf. Fromm 1976; Richins and Dawson 1992), that is, you either value things or you
value people, low-materialism people are proposed to place more importance to things
with private, personal meaning (Richins 1994). In short, the hypotheses tested by
Richins (1994) on an adult American sample were that consumers with different
levels of materialism will value different types of possessions. Compared to the
possessions valued by low-materialism consumers, high-materialism consumers will
value publicly, rather than privately, consumed possessions; more expensive
possessions; more statusoriented possessions; and possessions that are not connected
to significant others. These are also the hypotheses I here intend to test on Swedish
schoolchildren, partly in order to examine their generalizability over different age
groups and cultures, and partly because I suspect there will be certain differences. The
reasons for these differences are both culturally related and age-related. It is generally
assumed (at least in Sweden) that the US is the capital of consumption and that many
Americans consider consumption to be an important part of their lifestyle. In Sweden,
we like to think that we value other things more, as shown for example by the
negative associations many have to the word “consumer”. To quote from a recent
debate article: “There is an elite and then, there are the bulk children. The latter will
become consumers” (author’s translation; 334 / Material Values, Valued Possessions,
and Their Use: A Study of Schoolchildren Age Nine to Fifteen Aftonbladet May 10,
2005). Because of these different views, differences in the associations between
material values, other values, and valued possessions can be expected. On the other
hand, as previously noted, Swedish children on average possess comparatively large
amounts of money (Datamonitor 2004), which could also affect their material values
and associated constructs. When it comes to age-related differences, children may
have a different view of valued possessions than adults, because they have not yet
learnt that society places value on the possessions per se, or identifies you with the
things you own, tendencies which may of course vary between cultures/societies. In
sum, this reasoning leads to the following hypotheses: H1: Children with different
levels of materialism will value different types of possessions. In comparison with the
possessions valued by low-materialism children, highmaterialism children will
value… H1a: Publicly, rather than privately, consumed possessions. H1b: More
expensive possessions. H1c: More status-oriented possessions. H1d: Possessions that
are not connected to significant others. INTERRELATIONS BETWEEN
MATERIAL VALUES AND OTHER VALUES According to Richins (1994, 523),
“because low-materialism consumers care more strongly about interpersonal
relationships than do other individuals, they are more likely to cultivate possession
meanings that relate to interpersonal ties. High-materialism consumers, on the other
hand, place a greater emphasis on financial security than do low materialism
consumers (Richins and Dawson 1992); the private meaning of their possessions are
likely to relate to financial worth.” However, the interrelation between interpersonal
values, financial security, and material values has to my knowledge not been tested on
an interval, Likert-type scale, only with the ranking of the List of Values (Kahle 1983;
Richins and Dawson 1992). Moreover, it has not been tested on a sample of
schoolchildren (at least not Swedish schoolchildren). I would here like to examine if
there are any relations between material values, the value of interpersonal
relationships and the value of financial security among the schoolchildren age nine to
fifteen that I have studied. Thus, I also test the following hypotheses: H2: In
comparison with low-materialism children, high-materialism children put less weight
on interpersonal relationships. H3: In comparison with low-materialism children,
high-materialism children put more weight on financial security. STUDY AND
MEASURES Data Collection The data come from a survey of a variety of consumer
behaviors in Swedish schoolchildren age nine to fifteen. The questionnaires were
administered by the researcher in a classroom setting, and the study took place in
Degerfors, a rather small municipality of about 10,000 people in the middle of
Sweden. This had practical reasons, but pretests were made in the Stockholm area,
and results were similar, strengthening the belief in the representativeness of the
sample. That is, there does not seem to be any huge differences between urban and
small town Swedish children in these respects. So far, a total of 399 children and
adolescents have responded. Filling in the questionnaire was voluntary and required
parental consent. There were only two children who were not allowed to participate,
and none of the others declined to do so. Thus, except for a few being ill or away on
the day I was in their class, the response rate was near 100 percent. Materialism
Materialism was measured with translated versions of Richins’ (1987) Materialism
Measure, and Moschis and Churchill’s (1978) Materialistic Attitudes. Because the
items were, after pretests, somewhat adapted to be better understood by a younger age
group, they were not back-translated. The measures are thus not exactly comparable
to Richins and Dawson’s (1992) Materialism Scale, used in Richins (1994), but as
they are all validated measures of materialism listed in the Handbook of Marketing
Scales, they ought to measure the same construct. All items were measured on
fivepoint Likert-type scales where 1=strongly disagree and 5=strongly agree. More
specifically, they were: (1) Materialism Measure; “It is important to me to have really
nice things,” “I would like to be rich enough to buy anything I want,” “I’d be happier
if I could afford to buy more things,” “It sometimes bothers me quite a bit that I can’t
afford to buy all the things I want,” “People place too much emphasis on material
things” (reversed), and, “It’s really true that money can buy happiness” (α=.66,
M=3.14); (2) Materialistic Attitudes; “It’s really true that money can buy happiness
(this item is included in both measures),” “My dream in life is to be able to buy
expensive things”, “People judge others by the things they own,” “I buy some things
that I secretly hope will impress other people,” “Money is the most important thing to
consider in choosing a job,” “I think others judge me as a person by the kinds of
products and brands I use” (α=.69, M=2.70) The correlation between the two
measures was .655. For the purposes of this study, all 11 items were combined to an
overall materialism measure, with an α of .78. There were no significant differences
in the level of materialism between different age groups (though there were some
differences when it comes to valued possessions). Thus, children in the whole age
span are analyzed together. In line with Richins (1994), I used the upper quartile to
define the high-materialism group, and the lower quartile to define the low-
materialism group. In the high-materialism group, there were 100 members (25.1%)
and in the low-materialism group 114 members (28.6%), indicating a fairly balanced
distribution of material values in the sample. With regard to demographic variables, in
contrast to Richins (1994), who found no such differences between consumers high
and low in materialism, in this sample, there were small, but significant gender
differences between the groups: the high-materialism group included slightly more
boys (59.0%). Valued Possessions The survey included the question: “If your home
caught fire, which five things would you then consider most important to save?”
Richins (1994) let three independent judges who were blind to the level of
materialism of the respondents code their valued possessions according to whether (1)
it would normally be used in private, such as a photo album or bed, (2) it would be
visible in areas of the home normally available to guests (e.g., living room, dining
room, family room, kitchen), such as furniture or art objects; (3) it would be displayed
publicly at times by wearing the object, such as clothes or jewelry), (4) it would be
otherwise normally used in a public place, such as a car or golf clubs, or (5) its
visibility could not be determined. The coders also estimated the objects’ financial
European Advances in Consumer Research (Volume 7) / 335 values and categorized
them in different categories. The category of interest here is sentimental values
showing associations with important others (e.g., gifts, photo albums). In my study, I
first coded the things the respondents wanted to save from their burning homes in 25
categories on the physical object level. In a second step, I let four independent coders
classify these categories in a similar way to Richins (1994). They were instructed to
think as if they were being the same age as the respondents (coders from the original
sample was not available at the time being). At first, the agreement between the
coders was not perfect, but after discussion, in which they explained the reasons for
their choices, they agreed on the classification showed in table one. In order to test the
set of hypotheses H1a–H1d, I counted the amount of public, expensive, status-
oriented and people-oriented objects mentioned by each respondent. Value of
Interpersonal Relations The participants in my study were also asked a number of
questions about what they valued most in life. The answers were given on five-point
Likert-type scales where 1=not at all important, and 5=very important. The meaning
of each step in the scale was printed in the questionnaire in order to facilitate
responding for the youngest participants. Four of those items were related to family
and friends: (1) “How important is it for you to enjoy being at home and get along
with your family?”, (2) “How important is it for you to be popular among your
friends, to have many friends?”, (3) “How important is it for you to have a best
friend?”, and (4) “How important is it for you to have a girlfriend or boyfriend?”
Value of Financial Security (ability to purchase things and save money) I used three
items to measure the value of financial security: (1) “How important is it for you to be
able to buy everything you want?”, (2) How important is it for you to have a lot of
money?”, and (3) “How important is it for you to be able to save money?” It can be
argued that this is rather a measure of the importance of the ability to purchase and
save. However, financial security can be regarded as a prerequisite for this ability.
The constructs are thus considered related. I also asked a couple of questions about
saving, which can also be considered related to financial security, because the more
you save, the more money you have to make you feel financially secure. TABLE 1
Coders’ classification of possession types according to Richins’ (1994) categories
Possession type Public Expensive Status Sentimental Bed Books Cell phone x x
Clothes x Collection items (stamps, magazines) x x Computer x Computer games
Cuddly animals x Food Furniture x x Important papers Jewelry x Keys Money
Memories (drawings, family heirlooms) x Music equipment (CDs, stereo) x Musical
instruments x x x Photo albums x Safe Sports equipment x Things belonging to other
family members TV x Vehicles (moped, cross, bike) x x x VCR or DVD x x Wallet
(with credit cards) 336 / Material Values, Valued Possessions, and Their Use: A
Study of Schoolchildren Age Nine to Fifteen I asked the children if they save, how
much they save regularly, how much they have saved in total, and how happy they are
with their savings. These questions were included because whether high-materialism
consumers ought to save more or less than low-materialism consumers is not clear
cut. On one hand, high-materialism consumers may save more, because they want to
be able to buy more and more expensive things. On the other hand, their desires to
buy things may overshadow their willingness to save. RESULTS Hypothesis 1 stated
that children with different levels of materialism will value different types of
possessions. A cross-tab analysis with Fisher’s exact test shows that there were
significant differences in seven out of the 25 possession categories. Hypothesis 1 is
thus partly confirmed. The possession types where there were differences and the
percentage in each group mentioning them are listed in table two. Interestingly, sports
equipment was the only category where the low-materialism group was significantly
more likely to save things than the high-materialism group. The reason for this is
unclear. However, the actual difference is comparatively small. Even though the
respondents were asked to mention five things they wanted to save, some mentioned
fewer than five, and some mentioned a few more. Therefore, it would be interesting to
see if high-materialism children want to save not only different, but also more things.
Even though this hypothesis is not listed above and even though Richins (1994) found
no such differences, in this case, it turns out that they do. A mean comparison shows
that schoolchildren with high material values on average want to save more things
(M=3.29) than those with low material values (M=2.19) (F=19.079, df=213, p=.000).
In order to test hypotheses 1a through 1d, the number of objects mentioned by each
individual and classified by the coders as public, expensive, status-oriented, and
associated with other people (sentimental) was calculated. As we remember,
hypothesis 1a was that high-materialism consumers will value publicly, rather than
privately, consumed possessions compared to low-materialism consumers; hypothesis
1b was that high-materialism consumers will value more expensive possessions than
low-materialism consumers; hypothesis 1c was that high-materialism consumers will
value more status-oriented possessions than low-materialism consumers; and
hypothesis 1d was that high-materialism consumers will value possessions that are not
connected to significant others. A summary of the differences between high and low
materialism groups is found in table three. From the table, we see that hypotheses 1a–
1c were supported, but not hypothesis 1d. According to hypothesis 2, in comparison
with low-materialism children, high-materialism children ought to put less weight on
interpersonal relationships. A mean comparison between high and low materialism
children is shown in table four. Both groups value interpersonal relations highly, that
is, thought they were rather or very important. We see that if anything, high-
materialism consumers put greater weight on interpersonal relations with friends,
though not necessarily on family relationships. Thus, hypothesis 2 was not supported.
However, it is worth noting that the greater weight given to being popular and have a
TABLE 2 Percentages of high and low materialism groups that wanted to save
possessions in different product categories Possession type High Low Fisher’s exact
test materialism materialism (Exact sig. [2-sided]) Cell phone 34.0 14.0 .000 Clothes
42.0 21.1 .001 Computer 43.0 18.4 .000 Music equipment (CDs, stereo) 17.0 7.0 .032
Sports equipment 1.0 7.0 .039 TV 40.0 15.8 .000 Vehicles (moped, cross, bike) 10.0
2.6 .041 TABLE 3 Average number of possessions of each type mentioned by
children high and low in materialism Possession type High Low p materialism
materialism Public .91 .46 .000 Expensive .85 .50 .001 Status-oriented .56 .28 .000
Sentimental value .35 .34 .928 European Advances in Consumer Research (Volume
7) / 337 girlfriend or boyfriend by children that are high in materialism could be
interpreted as if they value their interpersonal relationships more for their status-
oriented or ownership qualities. Finally, hypothesis 3 stated that in comparison with
lowmaterialism consumers, high-materialism consumers put more weight on financial
security. Mean differences for the values related to financial security are reported in
table five. According to the above results, children high in materialism put greater
weight on financial security (purchase power and saving ability). Of course, the items
are similar to the items of the materialism scales, but you might still say that
hypothesis 3 was supported, measured in this way. When it comes to actual saving
behavior, however, it turns out that there are more high-materialism children that do
not save at all (15.2%) than low-materialism children (6.4%), high-materialism
children regularly save less (on average SEK 200 a month compared to SEK 243) and
have managed to save less in total (on average SEK 2263 compared to SEK 3553),
though none of these differences are significant. Moreover, there were insignificant
differences in satisfaction with saving pointing to low-materialism children being
more content than high-materialism children. So, even though hypothesis 3 was
supported, the increased weight put on financial security by high-materialism children
does not seem to be transferred to actual savings behavior. DISCUSSION The
findings that high-materialism consumers to a greater extent value possessions that
are publicly displayed, that is, visible TABLE 4 Mean values of children high and low
in materialism on items measuring interpersonal values Item High Low p materialism
materialism 1. How important is it for you to enjoy being at home 4.70 4.84 .109 and
get along with your family? 2. How important is it for you to be popular among your
3.85 3.25 .000 friends, to have many friends? 3. How important is it for you to have a
best friend? 4.29 4.01 .132 4. How important is it for you to have a girl-/boyfriend?
3.50 2.65 .000 TABLE 5 Mean values of high and low materialism groups on items
measuring value of financial security (purchase power) Item High Low p materialism
materialism 1. How important is it for you to be able to buy everything 3.81 2.61 .000
you want? 2. How important is it for you to have a lot of money? 4.34 3.32 .000 3.
How important is it for you to be able to save money? 4.20 3.95 .047 to others,
expensive, and status-oriented, have previously been confirmed for an American,
adult sample, and are here also confirmed for a Swedish sample of younger
consumers in the form of schoolchildren aged nine to fifteen. However, it is
interesting to note that high-materialism children in this study did not put lesser value
than low-materialism children on possessions symbolic of interpersonal relations,
such as photo albums or memories of different kinds. This leads to a questioning of
the popular assumption that people who put greater value on material things put lesser
value on personal relations. A mean comparison of questions about the importance of
interpersonal relations showed that high-materialism children value interpersonal
relations just as much as, and in some ways perhaps even more than, low-materialism
children. These two results together point to that materialism and valuing
interpersonal relations are not mutually exclusive personality traits. Rather, it seems
that at least for young Swedish consumers, material values are not related to the
importance you attach to interpersonal relations. Actually, most of the possessions
that highmaterialism children put greater value on are in fact used in interpersonal
relations. The primary function of a cell-phone is of course interpersonal
communication, which is also an important function of computers (e-mail, chat).
Likewise, music equipment, TV and different kinds of vehicles are often enjoyed
together with friends or family. Clothes are also important in a social context, not only
as a status-conveyor, but as a discussion topic and spare time activity (i.e., clothes
shopping). In sum, many of the possessions valued more by high-materialism children
are used to facilitate 338 / Material Values, Valued Possessions, and Their Use: A
Study of Schoolchildren Age Nine to Fifteen interpersonal relations, even though they
do not per se represent interpersonal relations. Aside from defining materialism as the
tendency to place possessions and their acquisition as central in one’s life, to view
possessions as a means to happiness, and as an indicator of own and others’ success
(Richins and Dawson 1992), which is also related to the tendency to perceive
interpersonal relations as less important (Richins 1994), material values might, at least
in Swedish schoolchildren, moreover represent an inclination to use possessions in
your interpersonal relations. A third result is that, as stated by Richins (1994),
material values are correlated with putting greater weight on financial security. But,
not necessarily on actual savings behavior, which in most cases is a prerequisite for
financial security. High-materialism children were not as good at saving money as
were low-materialism children. Neither were they as content with their savings (even
if none of these differences were significant, they all pointed in the proposed
direction). If material values in this way lead to opposite effects on attitudes and
behavior when it comes to saving, this can be problematic and cause even more
dissatisfaction in the highmaterialism young consumer. Both the relationships
between material values and interpersonal relations and the relationships between
material values and actual savings behavior should be examined more closely in
further research. According to this research, material values and interpersonal
relations are perhaps not opposite ends of the scale. Instead, both low and high
materialism children in this study valued interpersonal relations to a similar extent,
though they differ in their view on the use of publicly visible, expensive and status-
oriented things in managing successful interpersonal relations. Thus, it is not only the
relation between the individual consumer and product or brand that is important, but
also the relation between consumers through the product or brand. And if so,
interpersonal relations should be stressed in marketing communication also for this
type of products. Whereas the view on products as facilitators of interpersonal
relations would not be a great problem (as long as you can afford them), if material
values widens the gap between the weight attached to financial security and actual
saving, this could lead to customer dissatisfaction. Even though this is perhaps not a
marketing problem (because the marketer would in most cases encourage purchases
rather than saving), from a social marketing point-ofview, it could perhaps call for
further investigation. If we want to promote a healthy and happy savings behavior in
our young consumers, we should then perhaps encourage less material values.

Social Work Values Various portions of the Code of Ethics of the National
Association of Social Workers (NASW 2008) and the Educational Standards and
Accreditation Policy of the Council on Social Work Education (CSWE 2015) are
relevant to the integration of client religious/spiritual concerns into the delivery of
social work services and social work practice. Table 2.1 below delineates these
provisions. Emphasis has been added to draw the reader’s attention to those portions
of these provisions that are most relevant to this discussion. A reading of these
provisions of the NASW Code of Ethics and the CSWE Policy and Standards
suggests that ethical practice of social work demands that social workers recognize
and acknowledge each person as a unique individual, respond to the client holistically
and with care and respect, distinguish between the social worker’s personal values
and those of the client, and respect the client’s autonomy. Social work’s focus extends
beyond addressing the needs of individuals, however, to encompass those of groups
and communities. This attention to “the needs and empowerment of people who are
vulnerable, oppressed, and living in poverty” (NASW Code of Ethics) and social
work’s “quest for social and economic justice” (CSWE Policy and Standards) parallel
in various degrees the teachings of several faiths. Examples include liberation
theology’s “defence of the rights of the poor” (Aldunate 1994, 297), Catholic ethics’
“preferential option for the poor” (Pope 1993, 242), and Judaism’s emphasis on
communal welfare (Dorraj 1999). Biblical passages that underlie both Judaism and
Christianity suggest an obligation to care for the poor, the widowed, the fatherless,
Integrating Religion and Spirituality into Social Work Practice Engaging the Client
Individuals who present to social workers for services, whether for case management,
psychotherapy, or other services, present as whole persons, with body, mind, and soul
(Streets 2009). Social work’s emphasis on the dignity and worth of each individual
and on responsiveness to all individuals suggests the need for all social work
practitioners and educators to give greater priority to exploring the potential
significance of religious and spiritual beliefs in their training, in their professional
practice and in the lives and perspectives of service users and colleagues. Social
workers need to be able to respond appropriately to the needs of all service users,
including those for whom religious and spiritual beliefs are crucial. Culturally
competent practice depends, amongst other things, on an understanding and
appreciation of the impact of faith and belief (Gilligan and Furness 2006, p. 617).
Furman and colleagues identified a number of practice areas that would seem to lend
themselves to discussions with clients about their religious/spiritual beliefs and values
(Furman et al. 2005). These include the treatment of substance use and addiction,
issues relating to mental illness (see Chap. 9 of this volume), coping with the
diagnosis of a serious illness (see Chap. 11), mourning and preparing for the end of
life (see Chaps. 6 and 12), and issues relating to inclusion and exclusion (Chap. 18).
Social workers, in general, appear to recognize the need to develop the ability to work
with clients in an appropriate manner with respect to the clients’ religious and
spiritual beliefs and practices and their impact in the clients’ lives. A study conducted
by Canda and Furman (1999) revealed that the majority of respondents supported the
need to develop the requisite knowledge and skills to engage their clients on such
issues. A number of respondents noted that engagement with the client on issues of
spirituality and religion is consistent with several social work values and practices,
including upholding the dignity of the person and starting from where the client is.
Whether engagement with the client around issues of religion and spirituality raises
ethical concerns depends, in large part, on the nature of that engagement. Consider,
for example, the following possibilities: • The social worker discusses the client’s
religious/spiritual beliefs with the client; • The social worker discusses the social
worker’s religious/spiritual beliefs with the client; • The social worker recommends to
the client that he or she utilize a form of religious or spiritual healing; • The social
worker recommends that the client practice forgiveness or say penance; Integrating
Religion and Spirituality into Social Work Practice 23 • The social worker
recommends that the client develop religious or spiritual rituals as an intervention; •
The social worker utilizes healing touch with the client; • The social worker prays
together with the client during a session at the request of the client; • The social
worker initiates prayer with a client during a session; • The social worker prays for a
client outside of the practice setting and without the knowledge of the client; • The
social worker refers the client to an outside religious/spiritual helper or support
system; • The social worker collaborates with an outside religious/spiritual helper or
support system with the client’s knowledge and consent (Cf. Sheridan 2009). Each of
these various scenarios raises one or more ethical questions, e.g., the presence,
absence, or validity of client informed consent; client autonomy; unprofessional
conduct and/or a conflict of interest on the part of the social worker. A study by
Sheridan that sought respondent social workers’ thoughts about the ethics of some
such practices and their personal comfort level with each found that responses from
the majority of the participants were not derived from relevant ethical principles.
Sheridan concluded that these responses suggested “both overand under-utilization of
various activities [that] can result in unethical and ineffective practice” (Sheridan
2008, p. 14). Addressing Values Conflicts It is clear that social workers may be
challenged in some instances to separate their personal values from their professional
responsibilities and values (Streets 2009). Several examples are readily evident. A
social worker engaged in couples counseling who believes on the basis of his or her
faith that marriage should be afforded only to heterosexual couples may find it
difficult to provide competent services to a self-identified gay couple. A social worker
who is personally opposed to abortion under any circumstances or has had difficulty
conceiving a child despite numerous attempts may be conflicted when faced with a
client who is pregnant as the result of rape and is struggling to decide between an
abortion and a full-term pregnancy and adoption. In addressing such situations, it is
crucial that the social worker recognize and acknowledge his or her power that is an
integral component of social work, and critically analyze their role and the situation to
reduce the possibility that the power is being used coercively rather than to shape the
helping process in a manner that is beneficial to the client. The social worker’s power
stems from three sources: his or her expertise, interpersonal skills to develop trust and
rapport with the client, and legitimate power derived from dominant cultural values
and norms (Hasenfeld 1987). That said, the values and interests of the social w by the
policies of the organization for which he or she works, as in the case of a social
worker who believes that women should have the right to choose an abortion but who
works for a religious social service agency that prohibits any mention of abortion.
Further, the NASW Code of Ethics recognizes both that such conflicts may occur and
that the guidance offered by the Code is inadequate to resolve such dilemmas: The
Code offers a set of values, principles, and standards to guide decision making and
conduct when ethical issues arise. It does not provide a set of rules that prescribe how
social workers should act in all situations. Specific applications of the Code must take
into account the context in which it is being considered and the possibility of conflicts
among the Code’s values, principles, and standards. Ethical responsibilities flow from
all human relationships, from the personal and familial to the social and professional.
Further, the NASW Code of Ethics does not specify which values, principles, and
standards are most important and ought to outweigh others in instances when they
conflict. Reasonable differences of opinion can and do exist among social workers
with respect to the ways in which values, ethical principles, and ethical standards
should be rank ordered when they conflict. Ethical decision making in a given
situation must apply the informed judgment of the individual social worker and
should also consider how the issues would be judged in a peer review process where
the ethical standards of the profession would be applied … In addition to this Code,
there are many other sources of information about ethical thinking that may be useful.
Social workers should consider ethical theory and principles generally, social work
theory and research, laws, regulations, agency policies, and other relevant codes of
ethics, recognizing that among codes of ethics social workers should consider the
NASW Code of Ethics as their primary source. Social workers also should be aware
of the impact on ethical decision making of their clients’ and their own personal
values and cultural and religious beliefs and practices. They should be aware of any
conflicts between personal and professional values and deal with them responsibly
(National Association of Social Workers 2008) (emphasis added). There are several
potential courses of action open to the social worker in such situations. First, the
social worker is obligated to recognize and acknowledge this conflict in values and, if
he or she is to provide services to clients, to do so in a manner that adheres to the
ethical guidelines of the profession (Streets 2009). This would require that the social
worker strive to understand the client’s history and values and the role of
religion/spirituality in the client’s life. Bilich and colleagues offered an example of
how this might be accomplished when the social worker and the client hold different
faith beliefs: The therapist … must focus on understanding the [abuse] survivor’s
spiritual and religious world to be helpful. For example, let us take the case of a
Jewish therapist working with a Catholic survivor. If Jesus is important to the
survivor, the therapist’s task is to try to understand how Jesus is important in the
survivor’s life—what Jesus means to this person. An attempt by a Jewish therapist to
understand Jesus’ meaning in the life of another says nothing about that therapist’s
faithfulness to her own religion, but speaks to her willingness to be of service to
another. The therapist need not engage in theological discourse, but in an exploration
of the foundation of this person’s spiritual and religious beliefs and how those beliefs
influence her life (Bilich et al. 2000, p. 15). A second option is to work with the client
and to obtain competent consultation/supervision from a more experienced
professional during the course of Integrating Religion and Spirituality into Social
Work Practice 25 working with the client. This approach is recommended only if the
social worker believes that he or she can put aside his or her personal beliefs and
values and work with the client competently, recognizing that the client’s goals may
not be congruent with what the social worker might wish to see personally. This
approach may help the social worker to develop a deeper understanding of the client’s
situation and others in similar situations, which he or she might then apply in his or
her work with future clients. Finally, if the social worker feels that he or she cannot
provide the client with the necessary services at the level of competence that is
required, even with supervision, the social worker may be obliged to remove himor
herself from the case and refer the individual for the requisite services elsewhere
(Levy 1979). It has been argued that such values conflicts have given rise within
social work to the oppression of Evangelical Christians. What was once one large
middle class, it has been suggested, has become two ideologically divergent segments,
consisting of the old middle class largely involved with the production and
distribution of material goods and services and a “new class” that is concerned with
the production and distribution of knowledge (Berger 1986). According to Hodge
(2002), the social work profession has not only adopted the “new class” ideology, but
when an area of disagreement occurs between the religious values and “new class”
values (for example, sexual orientation), the profession’s guiding ethical principles
are superseded by its ideologically inspired drive to control the parameters of the
debate by excluding divergent [Evangelical] voices (Hodge 2002 p. 406). Whether the
social work profession has or has not adopted a “new class” ideology that serves as
the premise for the resolution of all values conflicts remains an open and relatively
unexplored question. While Hodge and others appropriately challenge the social work
profession to examine its own biases and prejudices and to provide safe spaces for the
discussion of divergent perspectives (Garland 1999; Hodge 2002; Thyer and Myers
2009), Hodge fails to acknowledge that, ultimately, a resolution in various situations
requires that competing values be prioritized and that the demarcation between
service delivery and proselytizing may be a fine one, indeed (Rice 2002; Sherr et al.
2009). In refuting Hodge’s claims, Sherr and colleagues note that Hodge premised his
argument entirely on a section of the National Association of Social Worker’s Code
of Ethics that urges social workers to obtain education related to diversity and
oppression, but neglected to mention social workers’ responsibility to apply “ethical
standards to set and maintain boundaries that are conducive to their clients’ well-
being, regardless of their own religious beliefs” (Sherr et al. 2009, p. 159). Consider,
as an example, a situation in which an adult who self-identifies as gay/homosexual is
feeling distress, not because of his sexual orientation, but because of his family’s
response to his disclosure. There are numerous potential courses of action open to the
social worker consulted in such a situation, each of which presents its own ethical
concerns. These include strategies such as (1) counseling the client to assist him in
dealing with his feelings of distress; (2) working with the client and his family to
increase his family’s understanding of 26 2 Social Work Values, Ethics, and
Spirituality homosexuality and client and family tolerance/acceptance of each other’s
beliefs; (3) recommending that the client refrain from homosexual practices in order
to repair his relationship with the family; and (4) referring the client to or providing
conversion therapy to facilitate the client’s “conversion” from homosexuality to
heterosexuality. A social worker who believes based on religious precepts that
homosexuality is wrong remains obligated to maintain boundaries and recommend a
course of action that respects the client’s autonomy, advances his well-being, and is
grounded in valid research. In this case, numerous studies have demonstrated the
potential for harm and the lack of benefit associated with conversion therapy, a
practice that has received the disapproval of various professional societies and state
governments (Drescher 1998; Haldeman 1991, 1994; Murphy 1992; Stein 1996). A
social worker’s referral of a client to or practice of conversion therapy violates the
social worker’s ethical obligations to the client. Similarly, a recommendation to the
client that he refrain from all sexual and romantic involvement with other men would
condemn the client to a life devoid of intimacy.n2 However the social worker decides
to address or resolve a particular situation, it is important that he or she be able to
articulate the analytical process used to arrive at their decision. For example, a social
worker may choose a course of action that the client opposes, believing that he or she
is acting in the client’s best interest and is adhering to the ethical principle of
beneficence, i.e., maximizing good. In doing so, however, the social worker may, in
fact, be guilty of paternalism, “a form of beneficence in which the helping person’s
concept of harms and benefits differ from those of the client and the helper’s
interpretation prevails” (Abramson 1989, p. 102; Mattison 2000, p. 202). An Ethical
Framework for Decision-Making Mattison (2000, p. 206) has suggested that all
decision-making proceed along a consistent sequence that includes (1) obtaining the
necessary background information and case details; (2) separating practice
consideration from ethical components; (3) identifying potential values conflicts; (4)
identifying relevant principles in the Code of Ethics; (5) identifying all possible
courses of action, together with their potential benefits, risks, costs, and outcomes; (6)
determining which obligation should be given priority and why; and (7) reaching a
resolution and implementing the decision. Although this progression may be helpful
in reaching a decision, it does not provide a foundation for decision making apart
from the standards enunciated in the National Association of Social Worker’s Code of
Ethics. It is suggested here that the four principles relied on in the context of
biomedical care—respect for persons, beneficence, nonmaleficence, and distributive
justice— would provide a solid foundation from which such an analysis could
proceed (see Chap. 22 for a more in-depth discussion of these principles). Respect for
persons comprises the requirement of informed consent and a recognition of
individual autonomy. Beneficence refers to the obligation to maximize good, while
Integrating Religion and Spirituality into Social Work Practice 27 nonmaleficence
seeks to minimize harm. The principle of distributive justice suggests that benefits
should be available to all who are eligible, regardless of their personal characteristics.
Consideration of and reference to these principles is consistent with the provisions of
the NASW Code of Ethics. The Code of Ethics encourages social workers to consider
ethical theory and principles in their ethical decisionmaking. The congruence between
these ethical principles and specific sections of the Code of Ethics is set forth in Table
2.2 below. The entire language of each of the relevant NASW standards has not been
provided, but can be found at https://www. socialworkers.org/pubs/code/code.asp.
Social Work Education Findings from various studies suggest that the majority of
practicing social workers and social work students have had little or no training
relating to spirituality and/or religion as part of their professional social work
education (Bullis 1996; Canda and Furman 1999; Cascio 1999; Dudley and Helfgott
1990; Furman et al. 2004; Gilligan and Furness 2006; Graf 2007; Heyman et al. 2006;
Joseph 1988; Kvarfordt and Sheridan 2007; Murdock 2005; Rizer and McColley
1996; Sheridan 2004; Sheridan and von-Hemert 1999; Sheridan et al. 1994). It has
been posited that, due to this lack of training, social workers have addressed issues of
religion and spirituality in practice in one or more of four ways, none of which is
optimal: (1) by Table 2.2 Congruence between four ethical principles and provisions
of NASW Code of ETHICS Ethical principle Provision(s) of the NASW code of
ethics Respect for persons Standard 1.02 Self-determination Standard 1.03 Informed
consent Standard 1.07 Privacy and confidentiality Beneficence Standard 1.01
Commitment to clients Standard 1.14 Clients who lack decision-making capacity
Nonmaleficence Standard 1.06 Conflicts of interest Standard 1.07 Privacy and
confidentiality Standard 1.09 Sexual relationships Standard 1.10 Physical contact
Standard 1.11 Sexual harassment Section 1.12 Derogatory language Section 1.15
Interruption of services Section 1.16 Termination of services Distributive Justice
Value: Social justice: Social workers strive to ensure access to needed information,
services, and resources, equality of opportunity; and meaningful participation in
decision making for all people 28 2 Social Work Values, Ethics, and Spirituality
resisting and avoiding the issues (2) by overgeneralizing (3) by radically divorcing the
concepts of religion and spirituality, and (4) by engaging in interdisciplinary
discussions between religious studies and social work (Pr Table 2.3 (continued)
Domain Content Social work value/standard/associated ethical principle Standard
1.05 Cultural competence and social diversity Standard 3.01(a) Supervision and
consultation Standard 3.02(a) Education and training Standard 3.08 Continuing
education and staff development Varieties of spiritual experiences Value: Service
Value Social justice Value: Competence Standard 1.04 Competence Standard 1.05
Cultural competence and social diversity Standard 3.01(a) Supervision and
consultation Standard 3.02(a) Education and training Standard 3.08 Continuing
education and staff development Theoretical perspectives, e.g., humanism,
postmodernism, transpersonal psychology, Jungian psychology Value: Service Value
Social justice Value: Competence Standard 1.04 Competence Standard 1.05 Cultural
competence and social diversity Standard 3.01(a) Supervision and consultation
Standard 3.02(a) Education and training Standard 3.08 Continuing education and staff
development NASW Code of Ethics; international social work standards and ethical
guidelines Value: Service Value Social justice Value: Competence Standard 1.04
Competence Standard 3.01(a) Supervision and consultation Standard 3.02(a)
Education and training Standard 3.08 Continuing education and staff development
State and national laws; relevant international agreements, treaties, conventions
Value: Service Value Social justice Value: Competence Standard 1.04 Competence
Standard 3.01(a) Supervision and consultation Standard 3.02(a) Education and
training Standard 3.08 Continuing education and staff development Skill acquisition
How to introduce religion and spirituality into social work practice Value: Service
Value: Social justice Value: Dignity and worth of the person Standard 1.01
Commitment to clients Assessing where the client is and how to start there Value:
Service Value: Social justice Value: Dignity and worth of the person Standard 1.01
Commitment to clients Standard 1.02 Self-determination Standard 1.03 Informed
consent Standard 1.04 Competence Standard 1.05 Cultural competence and social
diversity Maintaining a nonjudgmental approach Value: Service Value: Dignity and
worth of the person Standard 1.01 Commitment to clients Standard 1.02 Self-
determination (continued) 30 2 Social Work Values, Ethics, and Spirituality Table 2.3
(continued) Domain Content Social work value/standard/associated ethical principle
Understanding the client’s spiritual/religious journey and network Value: Service
Value: Dignity and worth of the person Value: Importance of human relationships
Standard 1.01 Commitment to clients Standard 1.02 Self-determination Standard 1.05
Cultural competence and social diversity Evaluating the need for a religious/spiritual
screen or assessment and identifying the appropriate screening/assessment instrument
Value: Service Value: Dignity and worth of the person Value: Competence Standard
1.02 Self-determination Standard 1.05 Cultural competence and social diversity
Identifying faith communities and associated resources Value: Service Value: Dignity
and worth of the person Value: Importance of human relationships Standard 1.05
Cultural competence and social diversity Integrating spirituality and/or religion into
goal setting and interventions Value: Service Value: Dignity and worth of the person
Value: Competence Standard 1.01 Commitment to clients Standard 1.02 Self-
determination Standard 1.03 Informed consent Standard 1.04 Competence Standard
1.05 Cultural competence and social diversity Developing an interprofessional
network, e.g., priests, pastors, rabbis, imams, ministers, and collaborations, as
appropriate Value: Importance of human relationships Value: Competence Standard
1.01 Commitment to clients Standard 1.04 Competence Standard 1.05 Cultural
competence and social diversity Standard 2.03 Interdisciplinary collaboration
Standard 2.06 Referral for services Understanding non-mainstream spiritual and
religious rituals and activities Value: Service Value Social justice Value: Competence
Standard 1.04 Competence Standard 1.05 Cultural competence and social diversity
Standard 3.01(a) Supervision and consultation Standard 3.02(a) Education and
training Standard 3.08 Continuing education and staff development Integrating
spiritual and/or religious rituals into practice, as appropriate and beneficial for the
client Value: Service Value: Dignity and worth of the person Value: Competence
Standard 1.01 Commitment to clients Standard 1.02 Self-determination Standard 1.03
Informed consent Standard 1.04 Competence Standard 1.05 Cultural competence and
social diversity (continued) Social Work Education 31 Notes 1. These passages state
as follows. (All passages from the Old and New Testaments are from Coogan (2007),
unless otherwise stated.) 17For the LORD your God is God of gods and LORD OF
LORDS, THE GREAT God, mighty and awesome, who is not partial and takes no
bribe, 18who executes justice for the orphan and the widow, and who loves the
strangers, providing them food and clothing. 19You shall also love the stranger, for
you were strangers in the land of Egypt. (Deut. 10:17–10, NRSV) Since there will
never cease to be some in need on this earth, I therefore command you, “Open your
hand to the poor and needy neighbor in your land.” (Deut. 15:11, NRSV) “Cursed be
anyone who deprives the alien, the orphan, and the widow of justice.” All the people
shall say, “Amen!” (Deut. 27:19, NRSV). 2. This situation is somewhat analogous to
that of judges who, based on their religious beliefs, are displeased with the recent
Supreme Court decision permitting marriage of same-sex couples, but are legally and
ethically bound to observe the ruling (Domonoske 2016)

Aesthetic value  

Synonyms

Aesthetic Merit, Aesthetic Quality, Artistic Value, Beauty

Definition

Aesthetic value is the value that an object, event or state of affairs (most
paradigmatically an art work or the natural environment) possesses in virtue of its
capacity to elicit pleasure (positive value) or displeasure (negative value) when
appreciated or experienced aesthetically.

Description

Everything that is valuable is valuable in a variety of ways. Art objects often have
sentimental value, historical value or financial value. Wilderness can have economic
value as well as recreational value. But great art works are thought to possess a
distinctive sort of non-instrumental and non-utilitarian value that is of central concern
when they are evaluated as art works. It might be thought that this value is beauty, but
many artworks are not beautiful. So it is more plausible that beauty is a particular
species of the value in question. The aesthetic value that a work of art possesses (and
most would extend this to the natural environment) has to do with the sort of
experience it provides when engaged with appropriately. If it provides pleasure in
virtue of our experience of its beauty, elegance, gracefulness, harmony, proportion,
unity, etc., we say that it has positive aesthetic value. If it provides displeasure in
virtue of ugliness, deformity or disgustingness we may say that it has negative
aesthetic value. One important thing to note is that the pleasure or displeasure
underwriting aesthetic value is best thought of as directed at the object in question
rather than being merely caused by it (Stecker, 1997).

The term 'aesthetic' (which is derived from the Greek word 'aesthesis', meaning
sensory perception) only gained philosophical currency in the eighteenth-century after
British Enlightenment theorists, such as Shaftesbury (1711), Hutcheson (1725), and
Hume (1757) had developed influential theories of the sense of beauty and the faculty
of taste - capacities that allegedly enable us to make judgements of beauty or ugliness.
Baumgarten's (1750) introduction of the term 'aesthetics' emphasised the sensory,
rather than intellectual, nature of such judgements. This then evolved into Kant's
(1790) conception of aesthetic judgements as non-conceptual and rooted entirely in
pleasure or displeasure. Kant distinguishes a sub-category of aesthetic judgments
(viz., judgments of the beautiful) that he characterizes as disinterested, i.e.,
independent of any interest in the existence or practical value of the object. This
Kantian conception of a disinterested judgment rooted in hedonic experience is the
foundation of many contemporary theories of aesthetic value.

The emphasis on pleasure and displeasure has always appeared to pose a challenge to
the objectivity of aesthetic value and aesthetic value judgments. But although some
believe aesthetic value to be a matter of pure personal preference, there has always
been strong philosophical resistance against such radical subjectivism. After all, we
do dispute about aesthetic matters and our disputes seem coherent. If aesthetics were
just a matter of personal preference such disputes would appear to be unmotivated and
irrational. Kant, for instance, considers aesthetic judgments 'subjective', in that they
are rooted in pleasure or displeasure, but he also claims that judgments of the
beautiful involves a claim to universality; that is, the judgment that something is
beautiful (and, hence, aesthetically valuable) involves the claim that others should
agree with us. And, as Hume emphasizes, we do not treat all judgments of taste as
equally valid. Furthermore, the ability of some works of art to pass the 'test of time'
seems to provide reason for thinking that aesthetic value is not simply relative to
individuals or cultures. So, radical subjectivism or anything goes relativism about
aesthetic value seem implausible. Nevertheless, while many philosophers reject
relativism altogether, some believe that a degree of relativism is characteristic of the
domain of aesthetic value (Hume, 1757; Goldman, 2001; Eaton, 2001).

Inspired by Kant's dissociation of aesthetic judgments from practical judgments,

aesthetic attitude theorists of the twentieth century (Bullough, 1912; Stolnitz, 1960)
defended the view that a particular, characteristically non-practical mode of
contemplating an object (disinterestedness or distance) allows one to recognize the
aesthetic features of objects and, hence, their aesthetic value. Yet the idea of a
specifically aesthetic attitude has been criticized (most notably by Dickie 1964) both
on grounds of psychological implausibility and because it excessively dissociates the
aesthetic from cognitive and moral value.

Current developments have therefore involved an expansion of the category of the

aesthetic. Aesthetic value is thus not restricted to the formal features of artworks, but
increasingly tends to be thought of as dependent on, or interacting with, a variety of
other aspects, most notably contextual, cognitive, and moral factors (Danto, 1981;
Walton, 1970; Gaut, 2007). Another trend is the development of virtue aesthetics,
which explores the psychological and behavioural dispositions that are most
conducive to the recognition and production of aesthetic value (Goldie, 2008; Kieran,
2010). The emerging fields of environmental aesthetics and everyday aesthetics
expand the scope of aesthetic value far beyond the arts so as to include virtually any
object (Carlson, 2000; Saito, 2007). Far from being a mere theoretical enterprise, a
central concern of these recent developments is to maximise the understanding of the
role aesthetic value may play in environmental policy (Brady, 2006, but see Loftis,
2003 for some sceptical considerations) and the way in which aesthetic value
contributes to our wellbeing and a good life (Eaton, 1989; Brady, 2006; Goldie, 2008;
Irvin, 2010).

Physiological values and procedures in the 24 h before ICU admission from the
ward

D. R. Goldhill 

 
S. A. White 

A. Sumner

First published: 06 April 2002

D. R. Goldhill , Senior Lecturer and Consultant Anaesthetist

Abstract

Physiological values and interventions in the 24 h before entry to intensive care
were collected for admissions from hospital wards. In a 13‐month period, there were
79 admissions in 76 patients who had been in hospital for at least 24 h and had not
undergone surgery within 24 h of admission to intensive care. Thirty‐four per cent
of patients underwent cardiopulmonary resuscitation before intensive care admission.
Using Acute Physiology and Chronic Health Evaluation II scoring to quantify
abnormal physiology in the group as a whole, a significant deterioration in respiratory
function before admission was found. During the 6‐h period immediately before
intensive care admission, 75% of patients received oxygen, 37% underwent arterial
blood gas sampling, and oxygen saturation was measured in 61% of patients, 63% of
whom had an oxygen saturation of less than 90%. Overall hospital mortality in the
study group was 58%. Information collected on the wards identified seriously ill
patients who may have benefited from earlier expert treatment.

Work conducted by the authors suggests that the patient group with the highest
mortality in Intensive Care Units (ICUs) comprises those patients admitted from the
hospital wards [1]. These patients have a higher mortality than patients admitted from
the operating theatres, the recovery area or the Accident and Emergency Department.
Cardiopulmonary resuscitation (CPR) preceded ICU admission in approximately 24%
of these patients. If ICU mortality rates are to be decreased, then the hospital inpatient
is an obvious target for increased medical intervention. Previous studies have shown
that in‐hospital cardiac arrests are commonly preceded by physiological abnormalities
[2, 3]. If admission to the ICU, or cardiac or respiratory arrest, are preceded by
specific physiological derangement, then early identification of these ‘high‐risk’
hospital inpatients may be possible. This would provide an opportunity for therapeutic
intervention with the aim of improving survival.

We hypothesised that patients admitted to ICU from the wards are often in hospital
and seriously ill for some time before ICU admission. By the time they are finally
admitted to ICU, they may be so sick that they die quickly or require a prolonged stay
in ICU in order to recover. If these patients can be recognised and treated earlier, it
may be possible to decrease mortality and the ICU stay of survivors. This study was
undertaken in order to describe the reasons for ICU admission in hospital inpatients
and to identify physiological values and interventions likely to be associated with a
patient at risk. These data have the potential to be used to formulate objective criteria
that could identify ward patients who might benefit from the attention of intensive
care physicians.

Methods

Ethics Committee approval was obtained for this study. All ICU admissions from the
wards in the Royal London Hospital over a 13‐month period from May 1995 were
prospectively examined. Patients were included in the study if they had been in
hospital for at least 24 h and had not undergone surgery in the 24 h immediately
before ICU admission. On admission to the ICU, all available written information on
these patients was examined, including medical, nursing and physiotherapy notes. For
each patient, we recorded age, date and time of hospital admission, date and time of
ICU admission, reason for ICU admission and details of chronic health problems,
previous surgery or intensive care.

For the 24‐h period immediately before ICU admission, the highest and lowest
recorded values of a number of physiological variables were noted: temperature, mean
arterial blood pressure, heart rate, respiratory rate, plasma sodium, potassium and
creatinine, haemoglobin and white cell count, Glasgow Coma Score (GCS), arterial
blood gas results and oxygen saturation (SpO2). The patient's urine output and any
indication of central nervous system depression were also noted. A record was made
if physiotherapy, continuous positive airway pressure (CPAP), administration of
oxygen, central venous access and monitoring, oxygen saturation monitoring or CPR
was provided. If oxygen was administered but there was no record of the inspired
concentration, this was assumed to be 40%.

The values for temperature, mean arterial blood pressure, heart rate, respiratory rate,
GCS and SpO2 were usually taken from nursing observation charts, with some results
being found in the medical or nursing history. Recorded temperature was assumed to
be a core value. The mean arterial pressure was calculated as being the diastolic blood
pressure plus one third of the difference between systolic and diastolic blood
pressures. The blood test results were commonly to be found in the medical history or
in laboratory results charts. If results were not in a patient's notes, the pathology
computer was searched for samples logged into the laboratory within the relevant time
period. For patients who received CPR, values recorded before resuscitation were
used in the analysis.
The 24 h immediately before ICU admission were divided into three time periods:
0–6 h, 6–12 h and 12–24 h before admission. Wherever possible, physiological
values, and procedures and interventions were noted for each of the time periods.
Patients were divided into those with primarily an airway, breathing or circulatory
reason for ICU admission. Patients admitted to ICU were grouped by time of day and
day of week of admission. The proportion of admissions with recordings of
physiological values and interventions was calculated for the 24 h before ICU
admission and for each of the three time periods. The highest Acute Physiology and
Chronic Health Evaluation II (APACHE II) [4] points were calculated for each of the
physiological variables, the GCS and for oxygenation (as defined in APACHE II) for
the 24 h before ICU admission. The GCS was only recorded if an accurate
assessment could be made. Zero APACHE II points were awarded for values in the
‘normal’ range. A maximum of four points were scored for each physiological
variable, apart from the GCS which scored 15 points minus the GCS, and creatinine,
for which points were doubled if the patient was suffering from acute renal failure [4].
To determine if there was a physiological deterioration before ICU admission,
APACHE II points for the variables were calculated for each of the three time periods
in the 24 h before ICU admission. This was only done if a value for the
physiological variable was available from each time period for at least 50% of the
admissions. An APACHE II score was calculated for 24 h before ICU admission by
summing the highest points for each physiological value and adding points for age
and chronic health problems [4]. An APACHE II score was also calculated for the
24 h after ICU admission. We recorded how long the patients were in hospital
before, during and after their ICU admission and whether they survived to leave ICU
and hospital. A comparison was made of physiological values and interventions
between patients who did and did not receive CPR before ICU admission.

Categorical data were analysed with the Chi‐squared test, using Yates' correction
where applicable. Continuous data were evaluated with the Mann–Whitney or
Student's t‐test. Statistical analysis with Chi‐squared for trend was used to test the
change in APACHE II points over the three time periods before ICU admission.
APACHE II points were used as this allowed the worst values to be used when
looking for trends. In order to avoid multiple testing, statistical analysis was only
performed if an inspection of the data suggested that there might be a difference.

Results

There were 923 admissions to the ICU during the study period. Of these admissions,
105 were transfers from other hospitals, 406 were from operating theatres or recovery,
244 were from the Accident and Emergency Department and 168 were from the
wards. Of the patients admitted from the wards, 63 had been in hospital for less than
24 h or had been readmitted to ICU within 24 h of discharge. Twenty‐six patients
were admitted from the wards within 24 h of surgery. The criteria for analysis were
fulfilled by 79 admissions in 76 patients, as three patients were admitted twice.

The patients studied were in hospital for a median (range, interquartile range) of 10
(1–75, 4–23.5) days before ICU admission. Admissions were spread throughout the
week with no obvious relationship to weekdays or weekends (Table 1). Most
admissions occurred between 08.00 and 20.00 hours.

Table 1. Day of week and time of day of Intensive Care admissions from the wards.

The primary reasons for ICU admission are shown in Table 2. The main event
precipitating ICU admission was categorised as being a problem with the airway,
breathing or circulation. The proportion of patients who received cardiopulmonary
resuscitation is given for the three diagnostic categories.

Table 2. Reason for Intensive Care Unit admission.

Serious chronic health problems were recorded using the definitions in APACHE II
[4]. They were common, occurring in 47% of the 76 patients. The criteria for chronic
health problems are specific and describe a severe restriction in activity or risk to life.
Twenty‐one patients (28%) had undergone surgery during their hospital admission
before ICU admission. In addition to the ICU admissions studied, 10 patients had a
further ICU admission that was not studied, six immediately following surgery and
four within 24 h of hospital admission. A further four ICU admissions in three
patients included in the study occurred after the study period.

The proportion of admissions where a physiological value was available for the 24 h
before admission ranged from 51% for oxygenation to 91% for sodium, potassium
and haemoglobin (Fig. 1). Although a blood test was usually performed at least once
during the 24 h before ICU admission, it was uncommon to have multiple results.
Values of the routine observations, temperature, blood pressure, heart rate and
respiratory rate, were available at some time in the 24 h before ICU for between
81% and 89% of admissions. The proportions of values available during the three
time periods before admission are given in Table 3.

Figure 1
Open in figure viewerPowerPoint
Proportion of patients with physiological values recorded in the 24‐h period before
ICU admission. temp = temperature; MAP = mean arterial blood pressure;
HR = heart rate; resp = respiratory rate; O2 = arterial blood gas results
allowing calculation of APACHE II oxygenation points; Na = sodium; K = 
potassium; creat = creatinine; Hb = haemoglobin; WBC = white cell count;
GCS = Glasgow Coma Score.

Table 3. Proportion of patients in whom physiological variables were measured

within three time periods before admission to the Intensive Care Unit.
Table 4 shows the APACHE II points based on the most extreme physiological
values for the 24‐h period before ICU admission. Some 80% of patients had recorded
values for heart rate, respiratory rate and oxygenation outside the ‘normal’ range, thus
scoring one or more APACHE II points. Statistical analysis of the change in
APACHE II points over the three time periods before ICU admission was performed
on temperature, mean arterial blood pressure, heart rate and respiratory rate as these
were the only variables for which more than 50% of values were available at all three
time periods. Only respiratory rate showed a statistically significant increase in
APACHE II points over time (p = 0.003).

Table 4. Mean APACHE II points and the proportion of patients scoring each of the
possible number of points (or range of points for the Glasgow Coma Score) in the 24‐
h period before Intensive Care Unit admission. * Creatinine points not doubled for

patients in acute renal failure

pH and oxygenation points required arterial blood gas analysis and many more
samples were taken in the 6 h before ICU admission than the other two time
periods. Over 70% of blood gas results showed abnormal oxygenation (APACHE II
points > 0) for all time periods, although pH was rarely outside the normal range
until the 6 h before ICU admission.

The proportions of admissions undergoing procedures or interventions are shown

in Table 5. Physiotherapy was performed on about 20% of patients with no increase
in treatment leading up to ICU admission. The physiotherapists usually supervise the
administration of CPAP. The proportion of patients on CPAP, although small,
doubled in the 24 h before ICU admission. The majority of patients were given
oxygen from at least 12 h before admission and this proportion had risen to 75% in
the final 6 h on the wards. At the time of the study, pulse oximeters were not readily
available on the wards and the fact that they were used on over 30% of patients at
least 12 h before ICU admission further suggests that these patients were
recognizably at risk. By the 6‐h period before ICU admission, some 60% of patients
were monitored. The need for oxygen therapy, and its ultimate ineffectiveness, is
illustrated by the high proportion of patients in whom a saturation of < 90% was
recorded in the period before ICU admission.

Table 5. Proportion of patients undergoing procedures or interventions before

Intensive Care Unit admission.

A total of 44 patients (55.7%) died during their hospital admission. There was no
statistical difference between those who did and did not receive CPR in the number of
ICU or hospital deaths, or in the APACHE II score before ICU admission (Table 6).
There was also no significant difference between the APACHE II score before and
after ICU admission (p = 0.055).

Table 6. APACHE II scores before and after ICU admission and ICU and mortality in
patients who did and did not undergo cardiopulmonary resuscitation (CPR).

Comparing patients who did and did not receive CPR before ICU admission,
univariate analysis was performed on the APACHE II points from the worst
physiological values in the 24‐h period before ICU admission. The probability values
for heart rate (p = 0.095), respiratory rate (p = 0.052) and pH (p = 0.087)
were less than 0.1.

Discussion

In this study we wished to focus on patients in whom intervention was possible and
may have made a difference to outcome. We therefore excluded ICU admissions
within 24 h of surgery or within 24 h of hospital admission. We did not collect
information on patients who were not admitted to the ICU, some of whom would have
had abnormal physiological values or may even have suffered cardiorespiratory arrest
and subsequent death. This study demonstrates that patients admitted to ICU from our
wards were seriously ill. The average pre‐admission APACHE II score was 19 and
34% of admissions followed CPR. A large proportion of patients had chronic health
problems and, in total, the 76 patients studied had 93 ICU admissions with an overall
hospital mortality of 58%.

Although it sometimes seems that a large proportion of ICU admissions from the
ward occur at 17.00 hours on a Friday, there was no clear pattern to the day of week
or time of day of the ICU admissions. Despite the patients' severity of illness, routine
physiological observations were not found in the notes of all patients. The data were
often recorded intermittently and imprecisely. There is a need for better charting of
observations. Despite these limitations, values for temperature, blood pressure, heart
rate and respiratory rate were available for most patients in the 24 h before ICU
admission. Using APACHE II points as a measure of physiological derangement,
heart rate and respiratory rate were the most abnormal of these four physiological
parameters. There was a significant worsening of the respiratory rate over the 24 h
before ICU admission, which did not occur with heart rate. A tachycardia may be an
important indicator that a patient is at risk but an increasing respiratory rate is likely
to be a better sign of the imminent need for ICU admission.

Although high GCS values were associated with the highest APACHE II points, this
is probably because up to 12 points can be derived from this score. Physiological
variables with low APACHE II scores, including sodium, potassium, temperature,
haemoglobin, white cell count and mean arterial pressure, are unlikely to give an early
indication of a patient at risk. The majority of patients received oxygen. An arterial
blood sample was commonly taken within 6 h of ICU admission and patients were
often monitored with a pulse oximeter. These findings suggest that medical staff
recognised that many of the patients were seriously ill and were providing some
additional monitoring and treatment. Despite this attention, many of the patients
deteriorated to the point where CPR became necessary.

Pre‐admission APACHE II scores were not able to identify patients who required
CPR. It is possible that many of those admitted to the ICU who did not receive CPR
had severely deranged physiological values and would have required CPR if left
longer on the wards. Our hospital does not possess a High Dependency Unit and
critically ill patients are managed on the wards before ICU admission. One reason that
patients may remain too long on the wards is the perceived difficulty of obtaining an
ICU bed. The problems of a multiple‐site hospital, unsatisfactory hand‐over of
patients, poor continuity of care and inexperienced and poorly supervised trainees
may all have contributed to the late recognition and inadequate treatment of patients
at risk.

Several studies have suggested that it is possible to recognise critically ill patients on
the wards and that outcome can often be improved. In an investigation of hospital
deaths from cerebrovascular accident, pneumonia or myocardial infarction, over one‐
quarter of deaths were thought to have been preventable [5]. In two‐thirds of 40
British medicolegal claims relating to patients admitted with acute medical
emergencies, clinicians either failed to recognise that the patients were very sick or
tried to manage a situation without having the necessary competence [6]. The paper
concluded that errors would probably not have happened in half the cases had
experienced clinical staff seen the patients shortly after admission. Schein et al. [3]
documented a clinical deterioration in 84% of patients within 8 h of an in‐hospital
arrest. Overall, 70% of patients had deterioration of either respiratory or mental
function, with 25% showing deterioration in both. Franklin and Mathew [4] found that
deterioration had been documented in 66% of patients who had an in‐hospital cardiac
arrest. Where a deterioration had been documented, they found that the patient
suffered an arrest either because the nurse did not inform the doctor (25%), junior
doctors did not inform senior doctors (43%) or intensive care doctors did not follow
usual procedures (32%). George et al. [7] found that death after in‐hospital CPR was
associated with pre‐arrest hypotension, renal failure and age over 64 years. A further
study [8] found that there was advance warning in almost all medical patients
experiencing a cardiac or respiratory arrest or an abrupt haemodynamic or respiratory
decompensation. The most important predictors were acute dyspnoea and
deterioration of their pre‐existing condition.

Our data suggest that respiratory rate, heart rate and the adequacy of oxygenation are
the most important physiological indicators of a critically ill ward patient. The level of
consciousness and presence of renal failure may also be important indicators. Urine
volume may be a useful measure but, in our hospital, observations were not
sufficiently detailed to be of value. Interventions such as administering oxygen,
placing a patient on CPAP or taking an arterial blood gas were carried out in many of
our patients before ICU admission. Because these interventions only follow
recognition that the patient is seriously ill and because their performance depends on
the policy and practice of the institution, they are less useful than physiological values
as part of an objective system to identify the patient at risk.
 If published guidelines for high‐dependency unit and ICU admission had been
followed, many of the ward patients would have been admitted at an earlier stage to a
critical care facility [9, 10]. Franklin et al. showed that opening a medical high‐
dependency unit in their hospital decreased mortality by 13.2% and the number of
cardiorespiratory arrests on the ward by 38.8% [11]. Few of our ICU admissions had
acute physiological deterioration or unheralded cardiac events. Many patients could
have been identified and admitted to a high‐dependency or intensive care unit earlier
and it is likely that most of the cardiorespiratory arrests on the wards before ICU
admission could have been prevented.

In order to provide appropriate care, critically ill hospital patients need to be identified
and managed expertly in a suitable location. A medical emergency team, as described
by Lee et al. [12], may be useful in the pre‐arrest situation, although even earlier
intervention to prevent physiological deterioration would be preferable [13]. Our
study echoes the findings of others [3, 6, 8] by suggesting that medical and nursing
staff are probably aware of most critically ill patients but, in many cases, do not
provide the appropriate treatment. Abnormal values of selected physiological
measurements may be useful as an objective indication that patients are at risk. If
unnecessary deaths are to be prevented, such patients must be assessed early by
experts in critical care medicine and resources must be made available to provide
these patients with appropriate treatment. Such treatment may be on the wards, in a
high‐dependency unit or in the ICU.

Spiritual values are human values

The values of truth, righteousness, peace, love and non-violence are found in all major
spiritual paths. These spiritual values are also human values and are the fundamental
roots of a healthy, vibrant, and viable work career.
 
Our collective business experience showed us that these five human values were the
fundamental roots of a healthy, vibrant, viable organisation – and of healthy, vibrant,
viable individuals. For example:
 

Truth fosters trust and honest communications.


Righteousness fosters high quality work. 


Peace fosters creative and wise decisions.


Love fosters self-less service based on caring for others' well being.


Non-violence fosters win-win collaboration.

 
Yet we have chosen to call them human values rather than spiritual values. “Spiritual
values” implies that they are something that human beings need to aspire to and
hopefully someday achieve. We are well aware that most people see human nature as
anything but spiritual – they typically see it as limited, imperfect, and so on. However,
we know that we are spiritual beings first and foremost and that “to be human is to be
spiritual.” So, by calling these spiritual values “human values,” it reminds us that they
are inherent in our spiritual nature.
 
We emphasise three principles:
 
1.
These human values do not need to be taught or learned; rather, they must be evoked
or unveiled, sometimes by unlearning the ways we keep them hidden.
2.
3.
These human values represent humanity at its fullest.
4.
5.
These human values can be understood from three perspectives:
6.
 

Their spiritual essence, based on the principle that Divinity resides in all of creation.


Their cross-cultural expressions, which we find in all societies though there may be
variations and different emphasis from culture to culture.


Their individual (personal) expressions, which reflect the attitudes and motivations
beneath our unique personalities and behaviour.

 
 While the spiritual essence of the human values is inherent within us, the cross-
cultural and individual expressions are learned, developed and practised throughout
our lifetime in the social environments we live and work in. By exploring the cross-
cultural and individual expressions of these five human values, we can bring them
forth in our everyday life and work.
 
One point we found quite interesting is that since these human values come from a
common spiritual foundation, they are an indivisible whole; one human value cannot
exist apart from the others. This integrated wholeness of the human values gives us
tremendous strength as we seek to bring them forth in our work.
 
So, what does each of these human values look like when expressed in the typical
workplace?
 

A professional would tell the truth about errors or delays, even if it meant a temporary
reprimand. 


A clerical person would do his or her best quality work, even if no one were watching.


An executive would continually strive to find creative new ways to deliver goods
effectively and efficiently, without adding undue costs to his or her customers. 


A sales person would actively seek to serve people rather than hide behind
bureaucratic rules. 


A manager would seek to keep the environment clean and unpolluted by wastes from
the business.

 
How can we practice all five human values in a practical way?
 
1.
Truthfulness: speak honestly with co-workers and customers.
2.
3.
Righteousness: keep your agreements with your manager and co-workers, as well as
customers.
4.
5.
Inner Peace: practice equanimity, even in crises, in times of profit or loss, and in times
of praise or blame.
6.
7.
Love: listen generously and compassionately to others rather than being judgmental.
8.
9.
Non-Violence: find win-win solutions to problems, rather than winning at another’s
expense.
10.