“Thinking Too Much”: A Clash of Legitimate Values in Clinical Practice Calls for an Indaba Guided by African Values-Based Practice

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Abstract This chapter applies African value-based practice (A-VBP) to the story of Akanya at two major decision points when values clashed: first between the general practitioner and Akanya’s parents when Akanya was acutely psychotic and required hospitalisation and second 8 years later, when Akanya wanted to discontinue his antipsychotic medication against medical advice. For both rather difficult decision points, the story illustrates how an indaba within A-VBP served as a practical process to take seriously and account for values that were clashing (i.e., uncommon ground), framed by values that were shared (i.e., common ground). The story underscores that dissensual decision-making affords more than default responses such as “I offer only what is medically best—take it or leave it” or alternatively “whatever the patient wants.”

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