case study on human values and ethics

• Browse All Articles
• Newsletter Sign-Up

ValuesandBeliefs →

No results found in working knowledge.

• Were any results found in one of the other content buckets on the left?
• Try removing some search filters.
• Use different search filters.

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• Review Article
• Published: 21 August 2017

Personal values in human life

• Lilach Sagiv 1 ,
• Sonia Roccas 2 ,
• Jan Cieciuch 3 , 4 &
• Shalom H. Schwartz 1 , 5  

Nature Human Behaviour volume  1 ,  pages 630–639 ( 2017 ) Cite this article

6071 Accesses

197 Citations

40 Altmetric

Metrics details

• Human behaviour

The construct of values is central to many fields in the social sciences and humanities. The last two decades have seen a growing body of psychological research that investigates the content, structure and consequences of personal values in many cultures. Taking a cross-cultural perspective we review, organize and integrate research on personal values, and point to some of the main findings that this research has yielded. Personal values are subjective in nature, and reflect what people think and state about themselves. Consequently, both researchers and laymen sometimes question the usefulness of personal values in influencing action. Yet, self-reported values predict a large variety of attitudes, preferences and overt behaviours. Individuals act in ways that allow them to express their important values and attain the goals underlying them. Thus, understanding personal values means understanding human behaviour.

This is a preview of subscription content, access via your institution

Access options

Access Nature and 54 other Nature Portfolio journals

Get Nature+, our best-value online-access subscription

24,99 € / 30 days

cancel any time

Subscribe to this journal

Receive 12 digital issues and online access to articles

111,21 € per year

only 9,27 € per issue

Buy this article

• Purchase on Springer Link
• Instant access to full article PDF

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

The idea of a theory of values and the metaphor of value-landscapes

Individual and generational value change in an adult population, a 12-year longitudinal panel study

Worldwide divergence of values

Williams, R. M. American Society: A Sociological Interpretation (Knopf, New York, 1970).

Schwartz, S. H. A theory of cultural values and some implications for work. Appl. Psychol. 48 , 23–47 (1999).

Article   Google Scholar  

Kluckhohn, C. in Toward a General Theory of Action (eds Parsons, T. & Shils, E.) 388–433 (Harvard Univ. Press, Cambridge, MA, 1951).

Rokeach, M. The Nature of Human Values (Free Press, New York, 1973).

Google Scholar  

Schwartz, S. H. Universals in the content and structure of values: theoretical advances and empirical tests in 20 countries. Adv. Exp. Soc. Psychol. 25 , 1–65 (1992).

Allport, G. W. & Vernon, P. A test for personal values. J. Abnorm. Soc. Psychol. 26 , 231–248 (1931).

Hitlin, S. & Piliavin, J. A. Values: reviving a dormant concept. Annu. Rev. Sociol. 30 , 359–393 (2004).

Maio, G. R. Mental representations of social values. Adv. Exp. Soc. Psychol. 42 , 1–43 (2010).

Rohan, M. J. A rose by any name? The values construct. Pers. Soc. Psychol. Rev. 4 , 255–277 (2000).

Schwartz, S. H. in Handbook of Value (eds Sander, D. & Brosch, T.) 63–84 (Oxford Univ. Press, Oxford, 2015).

Knafo, A., Roccas, S. & Sagiv, L. The value of values in cross cultural research: a special issue in honor of Shalom Schwartz. J. Cross Cult. Psychol. 42 , 178–185 (2011).

Hitlin, S. Values as the core of personal identity: drawing links between two theories of self. Soc. Psychol. Q. 66 , 118–137 (2003).

Roccas, S., Sagiv, L., Schwartz, S. H. & Knafo, A. The Big Five personality factors and personal values. Pers. Soc. Psychol. Bull. 28 , 789–801 (2002).

Roccas, S., Sagiv, L., Oppenheim, S., Elster, A. & Gal, A. Integrating content and structure aspects of the self: traits, values, and self-improvement. J. Pers. 82 , 144–157 (2014).

Article   PubMed   Google Scholar  

Roccas, S. & Sagiv, L. Personal values and behavior: taking the cultural context into account. Soc. Personal. Psychol. Compass 4 , 30–41 (2010).

Sagiv, L. & Roccas, S. in Values and Behavior: Taking a Cross-Cultural Perspective (eds Roccas, S. & Sagiv, L.) (Springer, in the press).

Schwartz, S. H. & Bardi, A. Value hierarchies across cultures: taking a similarities perspective. J. Cross Cult. Psychol. 32 , 268–290 (2001).

Schwartz, S. H. in The Ontario Symposium: The Psychology of Value Vol. 8 (eds Seligman, C., Olson, J. M. & Zanna, M. P.) 1–24 (Lawrence Erlbaum Associates, Inc, New Jersey, 1996).

Benish-Weisman, M. The interplay between values and aggression in adolescence: a longitudinal study. Dev. Psychol 51 , 677–687 (2015).

Vecchione, M., Döring, A. K., Alessandri, G., Marsicano, G. & Bardi, A. Reciprocal relations across time between basic values and value-expressive behaviors: a longitudinal study among children. Soc. Dev. 25 , 528–547 (2016).

Schwartz, S. H. et al. Refining the theory of basic individual values. J. Pers. Soc. Psychol. 103 , 663–688 (2012).

Schwartz, S. H. et al. Value tradeoffs propel and inhibit behavior: validating the 19 refined values in four countries. Eur. J. Soc. Psychol . 10.1002/ejsp.2228 (2016).

Davidov, E., Schmidt, P. & Schwartz, S. H. Bringing values back in: the adequacy of the European Social Survey to measure values in 20 countries. Public Opin. Q. 72 , 420–445 (2008).

Schwartz, S. H. & Rubel, T. Sex differences in value priorities: cross-cultural and multimethod studies. J. Pers. Soc. Psychol. 89 , 1010–1028 (2005).

Fontaine, J. R. J., Poortinga, Y. H., Delbeke, L. & Schwartz, S. H. Structural equivalence of the values domain across cultures: distinguishing sampling fluctuations from meaningful variation. J. Cross Cult. Psychol. 39 , 345–365 (2008).

Miles, A. The (re) genesis of values examining the importance of values for action. Am. Sociol. Rev. 80 , 680–704 (2015).

Hogg, M. A., Adelman, J. R. & Blagg, R. D. Religion in the face of uncertainty: uncertainty-identity theory of religiousness and religious extremism. Pers. Soc. Psychol. Rev. 14 , 72–83 (2010).

Ysseldyk, R., Matheson, K. & Anisman, H. Religiosity as identity: toward an understanding of religion from a social identity perspective. Pers. Soc. Psychol. Rev. 14 , 60–71 (2010).

Schwartz, S. H. & Huismans, S. Value priorities and religiosity in four Western religions. Soc. Psychol. Q. 58 , 88–107 (1995).

Bilsky, W. & Peters, M. Estructura de los valores y la religiosidad: una investigacion comparada realizada en Mexico. Revista Mexicana de Psicologia 16 , 77–88 (1999).

Fontaine, J. R. J., Luyten, P. & Corveleyn, J. Tell me what you believe and I’ll tell you what you want: empirical evidence for discriminating value patterns of five types of religiosity. Int. J. Psychol. Relig. 10 , 65–84 (2000).

Pepper, M., Jackson, T. & Uzzell, D. A study of multidimensional religion constructs and values in the United Kingdom. J. Soc. Sci. Study Relig. 49 , 127–146 (2010).

Saroglou, V. & Hanique, B. Jewish identity, values, and religion in a globalized world: a study of late adolescents. Identity 6 , 231–249 (2006).

Saroglou, V. & Galand, P. Identities, values, and religion: a study among Muslim, other immigrant, and native Belgian young adults after the 9/11 attacks. Identity 4 , 97–132 (2004).

Kusdil, M. E. & Kagitcibasi, C. Tuerk oegretmenlerin deger yoenelimleri ve Schwartz deger kurami [Value orientations of Turkish teachers and Schwartz’s theory of values]. Turk Psikoloji Dergisi 15 , 59–80 (2000).

Saroglou, V. & Dupuis, J. Being Buddhist in Western Europe: cognitive needs, prosocial character, and values. Int. J. Psychol. Relig. 16 , 163–179 (2006).

Saroglou, V., Delpierre, V. & Dernelle, R. Values and religiosity: a meta-analysis of studies using Schwartz’s model. Pers. Individ. Dif. 37 , 721–734 (2004).

Roccas, S. & Elster, A. in Religion, Personality, and Social Behavior (ed. Saroglou, V.) 193–212 (Psychology Press, New York, 2014).

Longest, K. C., Hitlin, S. & Vaisey, S. Position and disposition: the contextual development of human values. Soc. Forces 91 , 1499–1528 (2013).

Knafo, A. & Sagiv, L. Values and work environment: mapping 32 occupations. Eur. J. Psychol. Educ. 19 , 255–273 (2004).

Kristof-Brown, A. L., Zimmerman, R. D. & Johnson, E. C. Consequences of individual’s fit at work: a meta-analysis of person-job, person-organization, person-group, and person-supervisor fit. Pers. Psychology 58 , 281–342 (2005).

Kohn, M. L. Social class and parent-child relationships: an interpretation. Am. J. Sociol. 68 , 471–480 (1963).

Kohn, M. L. & Slomczynski, K. M. Social Structure and Self-Direction: A Comparative Analysis of the United States and Poland . (Blackwell, Oxford, 1993).

Kohn, M. L. & Schooler, C. Work and Personality: An Inquiry into the Impact of Social Stratification . (Ablex, New Jersey, 1983).

Kohn, M. L. et al. Complexity of activities and personality under conditions of radical social change: a comparative analysis of Poland and Ukraine. Soc. Psychol. Q. 63 , 187–207 (2000).

Arieli, S., Sagiv, L. & Cohen-Shalem, E. Values in business schools: the role of self-selection and socialization. Acad. Manage. Learn. Educ. 15 , 493–507 (2016).

Bardi, A., Buchanan, K. E., Goodwin, R., Slabu, L. & Robinson, M. P. Value stability and change during self-chosen life transitions: self-selection vs. socialization effects. J. Pers. Soc. Psychol. 106 , 131–147 (2014).

Gandal, N., Roccas, S., Sagiv, L. & Wrzesniewski, A. Personal value priorities of economists. Hum. Relat. 58 , 1227–1252 (2005).

Chatman, J. A. Matching people and organizations: selection and socialization in public accounting firms. Adm. Sci. Q. 36 , 459–484 (1991).

Bardi, A. & Schwartz, S. H. Values and behavior: strength and structure of relations. Pers. Soc. Psychol. Bull. 29 , 1207–1220 (2003).

Schwartz, S. H. et al. Value tradeoffs and behavior in four countries: validating 19 refined values. Eur. J. Soc. Psychol . 10.1002/ejsp.2228 (2017).

Sosik, J. J., Jung, D. I. & Dinger, S. L. Values in authentic action: examining the roots and rewards of altruistic leadership. Group & Organization Management 34 , 395–431 (2009).

Sanderson, R. & McQuilkin, J. in Values and Behavior: Taking a Cross-Cultural Perspective (eds Roccas, S. & Sagiv, L.) (Springer, in the press).

Maio, G. R., Pakizeh, A., Cheung, W. Y. & Rees, K. J. Changing, priming, and acting on values: effects via motivational relations in a circular model. J. Pers. Soc. Psychol. 97 , 699–715 (2009).

Arieli, S., Grant, A. M. & Sagiv, L. Convincing yourself to care about others: an intervention for enhancing benevolence values. J. Pers. 82 , 15–24 (2014).

Verplanken, B. & Holland, R. W. Motivated decision making: effects of activation and self-centrality of values on choices and behavior. J. Pers. Soc. Psychol. 82 , 434–447 (2002).

Maio, G. R. & Olson, J. M. Relations between values, attitudes, and behavioral intentions: the moderating role of attitude function. J. Exp. Soc. Psychol. 31 , 266–285 (1995).

Daniel, E., Bilgin, A. S., Brezina, I., Strohmeier, C. E. & Vainre, M. Values and helping behavior: a study in four cultures. Int. J. Psychol. 50 , 186–192 (2015).

Sagiv, L., Sverdlik, N. & Schwarz, N. To compete or to cooperate? Values’ impact on perception and action in social dilemma games. Eur. J. Soc. Psychol . 41 , 64–77.

Samuelson, C. D. A multiattribute evaluation approach to structural change in resource dilemmas. Organ. Behav. Hum. Decis. Process. 55 , 298–324 (1993).

Simpson, B. & Willer, R. Altruism and indirect reciprocity: the interaction of person and situation in prosocial behavior. Soc. Psychol. Q. 71 , 37–52 (2008).

Van Lange, P. A. The pursuit of joint outcomes and equality in outcomes: an integrative model of social value orientation. J. Pers. Soc. Psychol. 77 , 337–349 (1999).

Lönnqvist, J. E., Verkasalo, M., Wichardt, P. C. & Walkowitz, G. Personal values and prosocial behaviour in strategic interactions: distinguishing value‐expressive from value‐ambivalent behaviours. Eur. J. Soc. Psychol. 43 , 554–569 (2013).

Sagiv, L. & Schwartz, S. H. Value priorities and readiness for out-group social contact. J. Pers. Soc. Psychol. 69 , 437–448 (1995).

Sagiv, L., Makhamra, M. & Kluger, A. N. Direct and indirect influence of culture on managers’ willingness for cross cultural cooperation. In Proc. 3rd Annual Meeting of the Society of Personality and Social Psychology (SPSP, 2004).

Davidov, E. & Meuleman, B. Explaining attitudes towards immigration policies in European countries: the role of human values. J. Ethn. Migr. Stud. 38 , 757–775 (2012).

Davidov, E., Meuleman, B., Billiet, J. & Schmidt, P. Values and support for immigration: a cross-country comparison. Eur. Sociol. Rev. 24 , 583–599 (2008).

Davidov, E., Meulemann, B., Schwartz, S. H. & Schmidt, P. Individual values, cultural embeddedness, and anti-immigration sentiments: explaining differences in the effect of values on attitudes toward immigration across Europe. Kölner Zeitschrift für Soziologie und Sozialpsychologie 66 , 263–285 (2014).

Kuntz, A., Davidov, E., Schwartz, S. H. & Schmidt, P. Human values, legal regulation, and approval of homosexuality in Europe: a cross‐country comparison. Eur. J. Soc. Psychol. 45 , 120–134 (2015).

Donaldson, C. D., Handren, L. M. & Lac, A. Applying multilevel modeling to understand individual and cross-cultural variations in attitudes toward homosexual people across 28 European countries. J. Cross Cult. Psychol. 48 , 93–112 (2017).

Licciardello, O., Castiglione, C. & Rampullo, A. Intergroup contact, value system and the representation of homosexuality. Procedia Soc. Behav. Sci. 30 , 1467–1471 (2011).

Beierlein, C., Kuntz, A. & Davidov, E. Universalism, conservation and attitudes toward minority groups. Soc. Sci. Res. 58 , 68–79 (2016).

Roccas, S. & Amit, A. Group heterogeneity and tolerance: the moderating role of conservation values. J. Exp. Soc. Psychol. 47 , 898–907 (2011).

Bloom, P. B. N. & Bagno-Moldavsky, O. The conditional effect of network diversity and values on tolerance. Polit. Behav. 37 , 623–651 (2015).

Cieciuch, J. & Schwartz, S. H. in The Oxford Handbook of Human Essence (Oxford Univ. Press, Oxford, 2017).

Hofstede, G. Culture’s Consequences: Comparing Values, Behaviors, Institutions, and Organizations Across Nations . 2nd edn, (Sage, California, 2000).

Grossberg, S. How does a brain build a cognitive code? Psychol. Rev. 87 , 1–51 (1980).

Article   CAS   PubMed   Google Scholar  

Döring, A. K. et al. Cross‐cultural evidence of value structures and priorities in childhood. Br. J. Psychol. 106 , 675–699 (2015).

Lee, J. A., Ye, S., Sneddon, J. N., Collins, P. R. & Daniel, E. Does the intra-individual structure of values exist in young children? Pers. Individ. Dif. 110 , 125–130 (2017).

Cieciuch, J., Davidov, E. & Algesheimer, R. The stability and change of value structure and priorities in childhood: a longitudinal study. Soc. Dev. 25 , 503–527 (2016).

Benish-Weisman, M., Daniel, E. & Knafo-Noam, A. in Values and Behavior: Taking a Cross-Cultural Perspective (eds Roccas, S. & Sagiv, L.) (Springer, in the press).

Berzonsky, M. D., Cieciuch, J., Duriez, B. & Soenens, B. The how and what of identity formation: associations between identity styles and value orientations. Pers. Individ. Dif. 50 , 295–299 (2011).

Uzefovsky, F., Döring, A. K. & Knafo-Noam, A. Values in middle childhood: social and genetic contributions. Soc. Dev. 25 , 482–502 (2016).

Knafo, A. & Spinath, F. M. Genetic and environmental influences on girls’ and boys’ gender-typed and gender-neutral values. Dev. Psychol. 47 , 726–731 (2011).

Schermer, J. A., Feather, N. T., Zhu, G. & Martin, N. G. Phenotypic, genetic, and environmental properties of the Portrait Values Questionnaire. Twin Res. Hum. Genet. 11 , 531–537 (2008).

Vukasović, T. & Bratko, D. Heritability of personality: a meta-analysis of behavior genetic studies. Psychol. Bull. 141 , 769–785 (2015).

Schönpflug, U. Intergenerational transmission of values: the role of transmission belts. J. Cross Cult. Psychol. 32 , 174–185 (2001).

Knafo, A. & Schwartz, S. H. Value socialization in families of Israeli-born and Soviet-born adolescents in Israel. J. Cross Cult. Psychol. 32 , 213–228 (2001).

Whitbeck, L. B. & Gecas, V. Value attributions and value transmission between parents and children. J. Marriage Fam . 829–840 (1988).

Grusec, J. E. & Goodnow, J. J. Impact of parental discipline methods on the child’s internalization of values: A reconceptualization of current points of view. Dev. Psychol. 30 , 4–19 (1994).

Knafo, A. & Schwartz, S. H. Identity formation and parent‐child value congruence in adolescence. Br. J. Dev. Psychol. 22 , 439–458 (2004).

Knafo, A. & Schwartz, S. H. Parenting and adolescents’ accuracy in perceiving parental values. Child Dev. 74 , 595–611 (2003).

McPherson, M., Smith-Lovin, L. & Cook, J. M. Birds of a feather: homophily in social networks. Annu. Rev. Sociol. 27 , 415–444 (2001).

Bardi, A. & Goodwin, R. The dual route to value change: Individual processes and cultural moderators. J. Cross Cult. Psychol. 42 , 271–287 (2011).

Schwartz, S. H. in Valores e comportamento nas organizacións (eds Tamayo, A. & Porto, J. B.) 56–95 (Vozes, Petropolis, 2005).

Milfont, T. L., Milojev, P. & Sibley, C. G. Values stability and change in adulthood: a 3-year longitudinal study of rank-order stability and mean-level differences. Pers. Soc. Psychol. Bull. 42 , 572–588 (2016).

Lönnqvist, J. E., Jasinskaja-Lahti, I. & Verkasalo, M. Personal values before and after migration: a longitudinal case study on value change in Ingrian–Finnish migrants. Soc. Psychol. Pers. Sci 2 , 584–591 (2011).

Rokeach, M. Long-term value changes initiated by computer feedback. J. Pers. Soc. Psychol. 32 , 467–476 (1975).

Roccas, S., Sagiv, L. & Navon, M. in Values and Behavior: Taking a Cross-Cultural Perspective (eds Roccas, S. & Sagiv, L.) (Springer, in the press).

Bardi, A., Lee, J. A., Hofmann-Towfigh, N. & Soutar, G. The structure of intraindividual value change. J. Pers. Soc. Psychol. 97 , 913–929 (2009).

Cieciuch, J., Davidov, E., Vecchione, M., Beierlein, C. & Schwartz, S. H. The cross-national invariance properties of a new scale to measure 19 basic human values: A test across eight countries. J. Cross Cult. Psychol. 45 , 764–779 (2014).

Kluckhohn, F. R. & Strodtbeck, F. L. Variations in value orientations . (Row, Peterson, Illinois, 1961).

Hofstede, G. Culture’s consequences: international differences in work-related values . (Sage, California, 1980).

Inkeles, A. & Levinson, D. J. in The Handbook of Social Psychology 418–506 (1969).

Hofstede, G. & Bond, M. H. The Confucius connection: from cultural roots to economic growth. Organ. Dyn. 16 , 5–21 (1988).

Hofstede, G. J. & Minkov, M. Cultures and Organizations: Software of the Mind . 3rd edn, (McGraw-Hill, New York, 2010).

Hofstede, G. Dimensionalizing cultures: the Hofstede model in context. Online Readings Psychol. Cult . 2 , 10.9707/2307-0919.1014 (2011).

Schwartz, S. H. in Handbook of the Economics of Art and Culture Vol. 2, 547–586 (2014).

Inglehart, R. Modernization and postmodernization: cultural, economic, and political change in 43 societies . (Princeton Univ. Press, Chichester, 1997).

Inglehart, R. Mapping global values. Comp. Sociol. 5 , 115–136 (2006).

Inglehart, R. & Welzel, C. Modernization, Cultural Change, and Democracy: The Human Development Sequence . (Cambridge Univ. Press, Cambridge, 2005).

Book   Google Scholar  

House, R., Javidan, M. & Dorfman, P. Project GLOBE: an introduction. Appl. Psychol. Int. Rev. 50 , 489–505 (2001).

Smith, P. B., Dugan, S. & Trompenaars, F. National culture and the values of organizational employees a dimensional analysis across 43 nations. J. Cross Cult. Psychol. 27 , 231–264 (1996).

Hofstede, G. Culture’s recent consequences: using dimension scores in theory and research. Int. J. Cross Cult. Manag. 1 , 11–17 (2001).

Inglehart, R. The Silent Revolution: Changing Values and Political Styles Among Western Publics . (Princeton Univ. Press, Princeton, 2015).

Sagiv, L., Schwartz, S. H. & Arieli, S. in The Handbook of Organizational Culture and Climate (eds Ashkanasy, N. N., Wilderom, C. & Peterson, M. F.) 2nd edn, 515–537 (Sage, California, 2011).

Download references

Acknowledgements

This paper was partly funded by a grant from the Israel Science Foundation (847/14) to L.S. and S.R.; grants from the Recanati Fund of the School of Business Administration and the Mandel Scholion Interdisciplinary Research Center, both at the Hebrew University of Jerusalem, to L.S.; and a grant from The Open University Research Fund of the Open University of Israel to S.R. The work of J.C. was supported by the University Research Priority Program Social Networks of the University of Zurich.

Author information

Authors and affiliations.

School of Business Administration, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel

Lilach Sagiv & Shalom H. Schwartz

Department of Education and Psychology, The Open University of Israel, P. O. Box 808, 1 University Road, Raanana, 43107, Israel

Sonia Roccas

University of Zurich, URPP Social Networks, Andreasstrasse 15, CH-8050, Zurich, Switzerland

Jan Cieciuch

Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Wóycickiego 1/3 bud. 14, 01-938, Warsaw, Poland

Department of Psychology, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel

Shalom H. Schwartz

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Lilach Sagiv .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Cite this article.

Sagiv, L., Roccas, S., Cieciuch, J. et al. Personal values in human life. Nat Hum Behav 1 , 630–639 (2017). https://doi.org/10.1038/s41562-017-0185-3

Download citation

Received : 16 April 2017

Accepted : 27 July 2017

Published : 21 August 2017

Issue Date : September 2017

DOI : https://doi.org/10.1038/s41562-017-0185-3

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

This article is cited by

The paradox of pandemic mitigation moderating role of pandemic severity on the impact of social distancing policies: a cultural value perspective.

• Xingyang Ma
• Yufang Zhao

Globalization and Health (2024)

The influence of medical students’ life values on their perception of future professional activity during the Covid-19 pandemic

• Inna Diachenko
• Svitlana Kalishchuk
• Taras Bulanov

Current Psychology (2024)

Values and National Identification in Minority and Majority Youth: Longitudinal Multi-Study Findings

• Maya Benish-Weisman
• Ella Daniel
• Peter F. Titzmann

Journal of Youth and Adolescence (2024)

The relationships among online self-regulated english learning, task value, and academic self-efficacy: the mediating role of the task value

• Yossiri Yossatorn
• Nicholas O. Awuor

Safeguarding human values: rethinking US law for generative AI’s societal impacts

• Inyoung Cheong
• Aylin Caliskan
• Tadayoshi Kohno

AI and Ethics (2024)

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

McCombs School of Business

• Español ( Spanish )

Videos Concepts Unwrapped View All 36 short illustrated videos explain behavioral ethics concepts and basic ethics principles. Concepts Unwrapped: Sports Edition View All 10 short videos introduce athletes to behavioral ethics concepts. Ethics Defined (Glossary) View All 58 animated videos - 1 to 2 minutes each - define key ethics terms and concepts. Ethics in Focus View All One-of-a-kind videos highlight the ethical aspects of current and historical subjects. Giving Voice To Values View All Eight short videos present the 7 principles of values-driven leadership from Gentile's Giving Voice to Values. In It To Win View All A documentary and six short videos reveal the behavioral ethics biases in super-lobbyist Jack Abramoff's story. Scandals Illustrated View All 30 videos - one minute each - introduce newsworthy scandals with ethical insights and case studies. Video Series

Curated Resources UT Star Icon

Professional Ethics

Professionals work in a wide variety of settings and across many different industries including business, science, medicine, education, art, and public service.

Many professions have Codes of Conduct that specify ethical behavior and expectations particular to that industry. In addition, professionals must make ethical judgments in their area of specialty that fall outside their specific Code of Conduct.

The resources in this section offer insights that apply to a wide range of professionals as they seek to develop standards of ethical decision-making and behavior in their careers. Often, professionals need to apply moral reasoning to their interactions with co-workers, clients, and the general public to solve problems that arise in their work. Professionals also need to be on lookout for social and organizational pressures and situational factors that could cause them to err, unknowingly, in their ethical judgments and actions.

No profession is free from ethical dilemmas. All professionals will face ethical issues regardless of their career trajectory or the role they play within an organization. While Codes of Conduct are essential, and a good starting point for ethical conduct, they are no substitute for a well-rounded education in behavioral and applied ethics.

Start Here: Videos

Role Morality

Role morality is the tendency we have to use different moral standards for the different roles we play in society.

Bounded Ethicality

Bounded ethicality explains how social pressures and psychological processes cause us to behave in ways that are inconsistent with our own values.

Being Your Best Self, Part 4: Moral Action

Moral action means transforming the intent to do the right thing into reality. This involves moral ownership, moral efficacy, and moral courage.

Start Here: Cases

Freedom vs. Duty in Clinical Social Work

What should social workers do when their personal values come in conflict with the clients they are meant to serve?

High Stakes Testing

In the wake of the No Child Left Behind Act, parents, teachers, and school administrators take different positions on how to assess student achievement.

Healthcare Obligations: Personal vs. Institutional

A medical doctor must make a difficult decision when informing patients of the effectiveness of flu shots while upholding institutional recommendations.

Teaching Notes

Begin by viewing the “Start Here” videos. They introduce key topics that commonly emerge in our careers, such as making ethical decisions based on the role we’re playing at work. The four-part video,  Being Your Best Self , describes the four components of ethical decision-making and action. To help strengthen ethical decision-making skills, watch the behavioral ethics videos in the “Additional Videos” section to learn about the psychological biases that can often lead to making poor choices.

Read through these videos’ teaching notes for details and related ethics concepts. Watch the “Related Videos” and/or read the related Case Study. The video’s “Additional Resources” offer further reading and a bibliography.

To use these resources in the classroom, show a video in class, assign a video to watch outside of class, or embed a video in an online learning module such as Canvas. Then, prompt conversation in class to encourage peer-to-peer learning. Ask students to answer the video’s “Discussion Questions,” and to reflect on the ideas and issues raised by the students in the video. How do their experiences align? How do they differ? The videos also make good writing prompts. Ask students to watch a video and apply the ethics concept to course content.

The case studies offer examples of professionals facing tough ethical decisions or ethically questionable situations in their careers in teaching, science, politics, and social services. Cases are an effective way to introduce ethics topics, and for people to learn how to spot ethical issues.

Select a case study from the Cases Series  or find one in the “Additional Cases” section that resonates with your industry or profession. Then, reason through the ethical dimensions presented, and sketch the ethical decision-making process outlined by the case. Challenge yourself (and/or your team at work) to develop strategies to avoid these ethical pitfalls. Watch the case study’s “Related Videos” and “Related Terms” for further understanding.

To use the case studies in the classroom, ask students to read a video’s “Case Study” and answer the case study “Discussion Questions.” Then, follow the strategy outlined in the previous paragraph, challenging students to develop strategies to avoid the ethical pitfalls presented in the case.

Ethics Unwrapped  blogs  are also useful prompts to engage colleagues or students in discussions about ethics. Learning about ethics in the context of real-world (often current) events can enliven conversation and make ethics relevant and concrete. Share a blog in a meeting or class or post one to the company intranet or the class’s online learning module. To spur discussion, try to identify the ethical issues at hand and to name the ethics concepts related to the blog (or current event in the news). Dig more deeply into the topic using the Additional Resources listed at the end of the blog post.

Remember to review video, case study, and blogs’ relevant glossary  terms. In this way, you will become familiar with all the ethics concepts contained in these material. Share this vocabulary with your colleagues or students, and use it to expand and enrich ethics and leadership conversations. To dive deeper in the glossary, watch “Related” glossary videos.

Many of the concepts covered in Ethics Unwrapped operate in tandem with each other. As you watch more videos, you will become more fluent in ethics and see the interrelatedness of ethics concepts more readily. You also will be able to spot ethical issues more easily – at least, that is the hope! It will also be easier to express your ideas and thoughts about what is and isn’t ethical and why. Hopefully, you will also come to realize the interconnectedness of ethics and leadership, and the essential role ethics plays in developing solid leadership skills that can advance your professional career.

Additional Videos

• Self-serving Bias
• Moral Equilibrium
• Conflict of Interest
• In It To Win: The Jack Abramoff Story
• In It To Win: Jack & Framing
• In It To Win: Jack & Rationalizations
• In It To Win: Jack & Self-Serving Bias
• In It To Win: Jack & Role Morality
• In It To Win: Jack & Moral Equilibrium
• Intro to GVV
• GVV Pillar 1: Values
• GVV Pillar 2: Choice
• GVV Pillar 3: Normalization
• GVV Pillar 4: Purpose
• GVV Pillar 5: Self-Knowledge & Alignment
• GVV Pillar 6: Voice
• GVV Pillar 7: Reasons & Rationalizations
• Obedience to Authority
• Loss Aversion
• Intro to Behavioral Ethics
• Moral Muteness
• Moral Myopia
• Being Your Best Self, Part 1: Moral Awareness
• Being Your Best Self, Part 2: Moral Decision Making
• Being Your Best Self, Part 3: Moral Intent
• Legal Rights & Ethical Responsibilities

Additional Cases

Liberal arts & fine arts.

• A Million Little Pieces
• Approaching the Presidency: Roosevelt & Taft
• Pardoning Nixon

Science & Engineering

• Retracting Research: The Case of Chandok v. Klessig
• Arctic Offshore Drilling

Social Science

• The CIA Leak
• Edward Snowden: Traitor or Hero?
• The Costco Model
• The Collapse of Barings Bank
• Teaching Blackface: A Lesson on Stereotypes
• Cyber Harassment
• Cheating: Atlanta’s School Scandal

Communication & Journalism

• Dr. V’s Magical Putter
• Limbaugh on Drug Addiction
• Reporting on Robin Williams
• Covering Yourself? Journalists and the Bowl Championship
• Sports Blogs: The Wild West of Sports Journalism?
• Cheney v. U.S. District Court
• Negotiating Bankruptcy
• Patient Autonomy & Informed Consent
• Prenatal Diagnosis & Parental Choice

Public Policy & Administration

• Gaming the System: The VA Scandal
• Krogh & the Watergate Scandal

Stay Informed

Support our work.

Log in using your username and password

• Search More Search for this keyword Advanced search
• Latest content
• Current issue
• JME Commentaries
• BMJ Journals More You are viewing from: Google Indexer

You are here

• Volume 29, Issue 4
• Healthcare Ethics and Human Values: an Introductory Text with Readings and Case Studies
• Article Text
• Article info
• Citation Tools
• Rapid Responses
• Article metrics

• tuija.takala{at}helsinki.fi

https://doi.org/10.1136/jme.29.4.e3

Statistics from Altmetric.com

Request permissions.

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Edited by K W M (Bill) Fulford, D L Dickenson, T H Murray. Blackwell Publishers, 2002, £65.00 (hb), £17.99 (pb), pp xvi+496. ISBN 0–631–20224–2

Healthcare Ethics and Human Values is an impressive collection of ninety four short literary works. The editorial idea behind the volume is to show the diversity of values in bioethics rather than to provide a theoretically coherent whole. The book is intended to complement, or to counterpoint, the growing legalism in bioethics. According to the editors, contemporary quasilegal (bio)ethics relies on substantive ethical theories and aims at regulation in the light of particular values, while genuine “healthcare ethics” would utilise analytical ethical theory and celebrate partnership as an ideal in order to respect diverse values. “Healthcare ethics” is the editors’ answer to quasilegal bioethics. The main difference is the starting point—the diversity of values. The collected articles are there to show how shared values are an exception rather than the rule. The other differences can be found in the emphasis on ethics as a process (rather than a set of rules); communication as a substantive skill (rather than a means of execution); the clinical encounter as a whole (rather than just treatment); facts and diverse values (rather than facts and particular values), and partnership (rather than regulation).

The book starts with a general introduction that sets it in an academic context. The rest is divided into eight parts, with short introductions of their own. Suggestions for further reading are included in these. The first two parts of the book are slightly more theoretical, but soon the first hand narratives by patients and doctors, and indeed by poets and novelists, are given pride of place. The stories describe the lived experiences of people, actual or fictional, in the medical setting. Even the more theoretical chapters concentrate on the individual perspectives rather than on abstract principles. Part one introduces various contemporary approaches to bioethics, and aims to show the importance of philosophical traditions to healthcare ethics. Part two takes an excursion to the particular problems of screening and preventive medicine, especially in connection with genetic information.

The bulk of the book is a story of medical encounters (parts three to eight). These are organised chronologically, and a poem by Jenny Lewis about her breast cancer links the parts together. When I became an Amazon by Lewis relates a powerful medical history that guides the reader through the experiences of falling ill, having first contacts with medical professionals, deciding on the problem and the treatment, recovery, chronic illness, and ultimately death. The chapters are many and diverse. Some are philosophical, theoretical, and normative, while others take the reader through the pain, suffering, and hope of individuals in their own words, or as seen by a novelist or a poet. The editors have done an admirable job in collecting the contributions. The stories speak volumes.

Philosophically and practically, the introduction of the book opens up a number of important questions. The overarching presupposition is that in the reality of different and competing values any substantive regulation is likely to disregard some values at the expense of others. Whether this is for the good or for the bad is a more difficult question. The editors seem to hold that a dogmatic commitment to any particular set of values is unjustifiable. Many proponents of the quasilegal versions of ethics would disagree. The practical problem, of course, is that in fact we need some bioethical regulation. So, how should we strike a balance between quasilegal ethics and the new healthcare ethics to regulate when regulation is needed, while genuinely taking into account all the human values involved? Perhaps reading books like this could be a start.

Another practical problem acknowledged by the editors is to explain how the partnership model, as opposed to the more regulation driven models, would actually work. But this is not a serious problem. The new healthcare ethics advocated by the editors strongly emphasises substantive communication and personal narratives, and this reader at least, sees the value of the volume in starting a discussion rather than advocating any particular solution.

Healthcare Ethics and Human Values should be of interest to everyone working in the fields of bioethics, healthcare, and medicine. Indeed, it should be of interest to anyone who comes into contact with questions related to biomedical ethics. If nothing else, it should help the reader to widen her own perspective on different ethical viewpoints.

This collection is an invaluable tool for teachers of medical ethics. The selected texts in themselves are good for pedagogical purposes, the suggested readings help students further, and the analytic index as well as the whole structure of the book make it a highly useful device for teaching and learning purposes.

The introduction of the book critically describes today’s bioethics, and challenges it by posing questions that have, to a large extent, been dismissed. It asks many questions and gives some answers. The theoretical framework proposed by the editors is not perfect, nor conclusive, but it has the potential of taking bioethical discussions to a new level. Fulford, Dickenson, and Murray advocate an alliance of analytic ethical theory and empirical content, that is, a coalition between “cold” and neutral philosophical tools and “warm” and diverse human values. The idea, while not completely unheard of, has seldom been systematically developed. In a multicultural and pluralistic world it certainly merits further study.

What makes this book especially valuable, however, is the way in which the selected contributions succeed in covering such a wide variety of philosophical and theoretical, descriptive and intuitive viewpoints, and in the way it presents such a broad spectrum of ethical approaches. Moreover, the contributions are organised thematically, without giving priority to any particular set of values or points of view. This, I suppose, is healthcare ethics in action. All ninety four contributions tell stories, some normative and some simply descriptive. The rest is up to the reader, whose task it is to feel, analyse, interpret, and understand them.

Read the full text or download the PDF:

Other content recommended for you.

• Empirical research in bioethical journals. A quantitative analysis P Borry et al., Journal of Medical Ethics, 2006
• Systematic reviews of empirical bioethics D Strech et al., Journal of Medical Ethics, 2008
• The transformation of (bio)ethics expertise in a world of ethical pluralism József Kovács, Journal of Medical Ethics, 2010
• Highlights in bioethics through 40 years: a quantitative analysis of top-cited journal articles Pingyue Jin et al., Journal of Medical Ethics, 2017
• Science fiction in bioethics: a role for feminist narratology Evie Kendal, Medical Humanities, 2022
• Old problems in need of new (narrative) approaches? A young physician–bioethicist’s search for ethical guidance in the practice of physician-assisted dying in the Netherlands Bernadette Roest, Journal of Medical Ethics, 2020
• How do bioethics teachers in Japan cope with ethical disagreement among healthcare university students in the classroom? A survey on educators in charge K Itai et al., Journal of Medical Ethics, 2006
• Can bioethics be an honest way of making a living? A reflection on normativity, governance and expertise Silvia Camporesi et al., Journal of Medical Ethics, 2020
• The quality of bioethics debate: implications for clinical ethics committees L Williamson, Journal of Medical Ethics, 2008
• Teaching ethics in a Masters Program in Public Health in Lithuania Irayda Jakusovaite et al., Journal of Medical Ethics, 2007

Human Values in Corporate Social Responsibility: A Case Study of India

• First Online: 04 December 2021

Cite this chapter

• Aruna Das Gupta 4  

Part of the book series: CSR, Sustainability, Ethics & Governance ((CSEG))

350 Accesses

Values provide an in-built standard of reference and judgement for our actions. Values are by no means static, permanent and unchangeable. We may have good reasons for abandoning a value or incorporating a new one in our system, but that process involves its own justification and careful reckoning. The corporate sector in India is dominated by family firms, not only in terms of overall numbers, but also with respect to representation among the largest companies. Some of the more prominent of the family controlled business houses have a history of corporate philanthropy and involvement in community development dating back to the last century and the early part of this century. These commitments, in most instances instilled by the founder of the firm, have expressed themselves in a wide variety of areas.

Author Note: This chapter draws from the author’s previous publication published in International Journal of Business Ethics in Developing Economies; Vol 1; Issue 1;July, 2012. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info
• Durable hardcover edition

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

In (2nd ed.). (1987). Randon House Dictionary of the English language. New York.

Google Scholar  

Information got from NTPC‘s Official Web site. (15th March 2012).

Introduction chapter, Vedanta Kesari. Ramakrishna Mission, Mylapur, Chennai.

Jyothi, P. (2002, December, 6). School of Management Studies, Central University, Hyderabad; Paper presented at IIM Calcitta.

Kavarana, F. K. (1999–2001). Executive Director, Corporate Affairs, TATA Engineering, Tata Council for Community Initatives Report. Mumbai.

Kumar, R., Murrphy, D. F., & Balsari, V. Altered Images (2001). The 2001 State of Corporate Responsibility in India Poll, (TERI Report). New Delhi.

Mohan, A. (2001). Corporate Citizenship: Perspectives from India . Greenleaf Publishing Ltd.

Puspa, S. (2000). Beyond Business, Merchant Charity to Corporate Citizenship, 249. New Delhi: Tata McGraw- Hill.

Quoted in JRD Tata. (1986). Keynote, 40. Bombay: Tata Press.

Ramakrishna, B. (1970). Social role of Business, 52. Bombay: Maharashtra Chamber of Commerce. Retrieved from http://Business-Standard.Com/India/News/Rich-Learnartgiving-Back/468620/ .

Rich Learn the art of Giving Back. Business Standard/Mumbai (2012, March, 22).

Richard, M. L. (1980). Teaching Values in College, pp. 72-73. San Francisco: Jossey Bass Publishers.

Rima, D. C. (2002, December, 5). Officer HR, Calcutta: Haldia Petrochemicals Ltd, paper Presented at IIM Calcutta.

Tribute to Ethics. (1963), pp. 108–109. (1986). Ahmedabad: Gujarat Chamber of Commerce.

Values-The Key to a Meaningful Life. (2001). A Vedanta Kesari Presentation.

Download references

Author information

Authors and affiliations.

Independent Researcher On CSR, Bengaluru, India

Aruna Das Gupta

You can also search for this author in PubMed   Google Scholar

Editor information

Editors and affiliations.

Indian Institute of Plantation Management, Bengaluru, Karnataka, India

Ananda Das Gupta

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Singapore Pte Ltd.

About this chapter

Das Gupta, A. (2022). Human Values in Corporate Social Responsibility: A Case Study of India. In: Das Gupta, A. (eds) A Casebook of Strategic Corporate Social Responsibility. CSR, Sustainability, Ethics & Governance. Springer, Singapore. https://doi.org/10.1007/978-981-16-5719-1_1

Download citation

DOI : https://doi.org/10.1007/978-981-16-5719-1_1

Published : 04 December 2021

Publisher Name : Springer, Singapore

Print ISBN : 978-981-16-5718-4

Online ISBN : 978-981-16-5719-1

eBook Packages : Religion and Philosophy Philosophy and Religion (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• J Med Ethics
• v.29(4); 2003 Aug

Healthcare Ethics and Human Values: an Introductory Text with Readings and Case Studies

The Full Text of this article is available as a PDF (56K).

Princeton Dialogues on AI and Ethics

Princeton University

Case Studies

Princeton Dialogues on AI and Ethics Case Studies

The development of artificial intelligence (AI) systems and their deployment in society gives rise to ethical dilemmas and hard questions. By situating ethical considerations in terms of real-world scenarios, case studies facilitate in-depth and multi-faceted explorations of complex philosophical questions about what is right, good and feasible. Case studies provide a useful jumping-off point for considering the various moral and practical trade-offs inherent in the study of practical ethics.

Case Study PDFs : The Princeton Dialogues on AI and Ethics has released six long-format case studies exploring issues at the intersection of AI, ethics and society. Three additional case studies are scheduled for release in spring 2019.

Methodology : The Princeton Dialogues on AI and Ethics case studies are unique in their adherence to five guiding principles: 1) empirical foundations, 2) broad accessibility, 3) interactiveness, 4) multiple viewpoints and 5) depth over brevity.

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to  upgrade your browser .

Enter the email address you signed up with and we'll email you a reset link.

• We're Hiring!
• Help Center

Professional Ethics and Human Values

Related Papers

SSRN Electronic Journal

Muel Kaptein

Soona Rizqa

Santosh Venkat

RAJA RAO PAGIDIPALLI

Human Values & Professional Ethics and The Last Leaf for B.Tech 1st Year English

Sourav Bera

Engineering, Construction and Architectural Management

Muhammad Talha

David Appelbaum

The British journal of psychiatry : the journal of mental science

Linda van Diermen

SummaryThis notice describes a correction to the above mentioned paper.

Bulletin of the American Physical Society

Liudmila Pozhar

Vitaliy Nagirnyy

RELATED PAPERS

Aseguramiento Calidad TFT PERU SAC

Revista de Enseñanza de la Física

Marta Pontin Darsie

Journal of Environmental Engineering and Waste Management

riyanto adji

Revista Brasileira de Ciência do Solo

Antonio Cruz

Sifat Zat (IPA SMP)

Miftahul Jannah Fitri

Critical Reviews in Environmental Science and Technology

Paul McCormick

Ann-katrien Lescrauwaet

Journal of Clinical Investigation

Daniel Drane

VTI Rapport

Sonja Forward

Dhruv Mishra

European Scientific Journal

Abubakar Muhammad

Rudolf Pušenjak

Zenodo (CERN European Organization for Nuclear Research)

La Ode Muhammad Elwan

Diklabio: Jurnal Pendidikan dan Pembelajaran Biologi

Lina Herlina

nadyah srgh

Journal of Dental Specialities

Anam Khushboo Khan

The International Review of Research in Open and Distributed Learning

Prof. Joel S Mtebe

•   We're Hiring!
•   Help Center
• Find new research papers in:
• Health Sciences
• Earth Sciences
• Cognitive Science
• Mathematics
• Computer Science
• Academia ©2024

Persistent symptoms and clinical findings in adults with post-acute sequelae of COVID-19/post-COVID-19 syndrome in the second year after acute infection: population-based, nested case-control study

• Find this author on Google Scholar
• Find this author on PubMed
• Search for this author on this site
• ORCID record for Raphael S Peter
• ORCID record for Alexandra Nieters
• ORCID record for Siri Göpel
• ORCID record for Uta Merle
• ORCID record for Jürgen M Steinacker
• ORCID record for Peter Deibert
• ORCID record for Birgit Friedmann-Bette
• ORCID record for Andreas Niess
• ORCID record for Barbara Müller
• ORCID record for Claudia Schilling
• ORCID record for Gunnar Erz
• ORCID record for Roland Giesen
• ORCID record for Veronika Götz
• ORCID record for Karsten Keller
• ORCID record for Philipp Maier
• ORCID record for Lynn Matits
• ORCID record for Sylvia Parthé
• ORCID record for Martin Rehm
• ORCID record for Jana Schellenberg
• ORCID record for Ulrike Schempf
• ORCID record for Mengyu Zhu
• ORCID record for Hans-Georg Kräusslich
• ORCID record for Dietrich Rothenbacher
• ORCID record for Winfried V. Kern
• For correspondence: [email protected]
• Info/History
• Supplementary material
• Preview PDF

Objective: To assess risk factors for persistence vs improvement and to describe clinical characteristics and diagnostic evaluation of subjects with post-acute sequelae of COVID-19/post-COVID-19 syndrome (PCS) persisting for more than one year. Design: Nested population-based case-control study. Setting: Comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise, and laboratory testing in four university health centres in southwestern Germany (2022). Participants: PCS cases aged 18 to 65 years with (n=982) and age and sex-matched controls without PCS (n=576) according to an earlier population-based questionnaire study (six to 12 months after acute infection, phase 1) consenting to provide follow-up information and to undergo clinical diagnostic assessment (phase 2, another 8.5 months [median] after phase 1). Main outcome measures: Relative frequencies of symptoms and health problems and distribution of symptom scores and diagnostic test results between persistent cases and controls. Additional analysis included predictors of changing case or control status over time with adjustments for potentially confounding variables. Results: At the time of clinical examination (phase 2), 67.6% of the initial cases (phase 1) remained cases, whereas 78.5% of the controls continued to report no health problems related to PCS. In adjusted analyses, predictors of improvement among cases were mild acute index infection, previous full-time employment, educational status, and no specialist consultation and not attending a rehabilitation programme. Among controls, predictors of new symptoms or worsening with PCS development were an intercurrent secondary SARS-CoV-2 infection and educational status. At phase 2, persistent cases were less frequently never smokers, had higher values for BMI and body fat, and had lower educational status than controls. Fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness and anxiety/depression/sleep problems remained the predominant symptom clusters, and exercise intolerance with post-exertional malaise for >14 h (PEM) and symptoms compatible with ME/CFS (according to Canadian consensus criteria) were reported by 35.6% and 11.6% of persistent cases, respectively. In adjusted analyses, significant differences between persistent cases and stable controls (at phase 2) were observed for neurocognitive test performances, scores for perceived stress and subjective cognitive disturbances, symptoms indicating dysautonomia, depression and anxiety, sleep quality, fatigue, and quality of life. In persistent cases, handgrip strength, maximal oxygen consumption, and ventilator efficiency were significantly reduced. However, there were no differences in measures of systolic and diastolic cardiac function, in the level of pro-BNP blood levels or other laboratory measurements (including complement activity, serological markers of EBV reactivation, inflammatory and coagulation markers, cortisol, ACTH and DHEA-S serum levels). Screening for viral persistence (based on PCR in stool samples and SARS-CoV-2 spike antigen levels in plasma in a subgroup of the cases) was negative. Sensitivity analyses (pre-existing illness/comorbidity, obesity, PEM, medical care of the index acute infection) revealed similar findings and showed that persistent cases with PEM reported more pain symptoms and had worse results in almost all tests. Conclusions: This nested population-based case-control study demonstrates that the majority of PCS cases do not recover in the second year of their illness, with patterns of reported symptoms remaining essentially similar, nonspecific and dominated by fatigue, exercise intolerance and cognitive complaints. We found objective signs of cognitive deficits and reduced exercise capacity likely to be unrelated to primary cardiac or pulmonary dysfunction in some of the cases, but there was no major pathology in laboratory investigations. A history of PEM >14 h which was associated with more severe symptoms as well as with more objective signs of disease may be a pragmatic means to stratify cases for disease severity.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work was funded by the Baden-Wuerttemberg Federal State Ministry of Science and Art (grant number MR/S028188/1).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained from the Ethics Committee of the University of Freiburg, Engelberger Strasse 21, D-79106 Freiburg/Germany (#21/1484_1), the Ethics Committee of the Medical Faculty of Heidelberg University, Alte Glockengiesserei 11/1, D-69115 Heidelberg/Germany (#S-846/2021), the Ethics Committee at the Medical Faculty of the Eberhard-Karls-University and at the University Hospital of Tuebingen, Gartenstrasse 47, D-72074 Tuebingen/Germany (#845/2021BO2), and the Ethic Committee of the University of Ulm, Oberberghof 7, D-89081 Ulm/Germany (#337/21).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

View the discussion thread.

Supplementary Material

Thank you for your interest in spreading the word about medRxiv.

NOTE: Your email address is requested solely to identify you as the sender of this article.

Citation Manager Formats

• EndNote (tagged)
• EndNote 8 (xml)
• RefWorks Tagged
• Ref Manager
• Tweet Widget
• Facebook Like
• Google Plus One
• Addiction Medicine (324)
• Allergy and Immunology (632)
• Anesthesia (168)
• Cardiovascular Medicine (2397)
• Dentistry and Oral Medicine (289)
• Dermatology (207)
• Emergency Medicine (381)
• Endocrinology (including Diabetes Mellitus and Metabolic Disease) (846)
• Epidemiology (11789)
• Forensic Medicine (10)
• Gastroenterology (705)
• Genetic and Genomic Medicine (3763)
• Geriatric Medicine (350)
• Health Economics (637)
• Health Informatics (2406)
• Health Policy (937)
• Health Systems and Quality Improvement (904)
• Hematology (342)
• HIV/AIDS (785)
• Infectious Diseases (except HIV/AIDS) (13337)
• Intensive Care and Critical Care Medicine (769)
• Medical Education (367)
• Medical Ethics (105)
• Nephrology (401)
• Neurology (3521)
• Nursing (199)
• Nutrition (528)
• Obstetrics and Gynecology (677)
• Occupational and Environmental Health (667)
• Oncology (1830)
• Ophthalmology (538)
• Orthopedics (220)
• Otolaryngology (287)
• Pain Medicine (234)
• Palliative Medicine (66)
• Pathology (447)
• Pediatrics (1036)
• Pharmacology and Therapeutics (426)
• Primary Care Research (424)
• Psychiatry and Clinical Psychology (3186)
• Public and Global Health (6175)
• Radiology and Imaging (1288)
• Rehabilitation Medicine and Physical Therapy (751)
• Respiratory Medicine (831)
• Rheumatology (380)
• Sexual and Reproductive Health (372)
• Sports Medicine (324)
• Surgery (403)
• Toxicology (50)
• Transplantation (172)
• Urology (147)