Document Detail

Whither our art? Clinical wisdom and evidence-based medicine.
MedLine Citation:
PMID:  12517035     Owner:  NLM     Status:  MEDLINE    
The relationship between evidence-based medicine (EBM) and clinical judgement is the subject of conceptual and practical dispute. For example, EBM and clinical guidelines are seen to increasingly dominate medical decision-making at the expense of other, human elements, and to threaten the art of medicine. Clinical wisdom always remains open to question. We want to know why particular beliefs are held, and the epistemological status of claims based in wisdom or experience. The paper critically appraises a number of claims and distinctions, and attempts to clarify the connections between EBM, clinical experience and judgement, and the objective and evaluative categories of medicine. I conclude that to demystify clinical wisdom is not to devalue it. EBM ought not be conceived as needing to be limited or balanced by clinical wisdom, since if its language is translatable into terms comprehensible and applicable to individuals, it helps constitute clinical wisdom. Failure to appreciate this constitutive relation will help perpetuate medical paternalism and delay the adoption of properly evidence-based practice, which would be both unethical and unwise.
Malcolm Parker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medicine, health care, and philosophy     Volume:  5     ISSN:  1386-7423     ISO Abbreviation:  Med Health Care Philos     Publication Date:  2002  
Date Detail:
Created Date:  2003-01-08     Completed Date:  2003-01-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9815900     Medline TA:  Med Health Care Philos     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  273-80     Citation Subset:  E; IM    
School of Medicine, University of Queensland, Herston, QLD, Australia 4006.
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MeSH Terms
Clinical Competence
Evidence-Based Medicine / ethics*
Practice Guidelines as Topic*
Professional Autonomy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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