Document Detail

On evidence and evidence-based medicine: lessons from the philosophy of science.
MedLine Citation:
PMID:  16384628     Owner:  NLM     Status:  MEDLINE    
The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920-1950). At the same time, the term "evidence-based medicine" has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should be challenged on the grounds of how 'evidence' has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause.
Maya J Goldenberg
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Publication Detail:
Type:  Journal Article     Date:  2005-12-27
Journal Detail:
Title:  Social science & medicine (1982)     Volume:  62     ISSN:  0277-9536     ISO Abbreviation:  Soc Sci Med     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-04-28     Completed Date:  2006-11-03     Revised Date:  2011-12-29    
Medline Journal Info:
Nlm Unique ID:  8303205     Medline TA:  Soc Sci Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  2621-32     Citation Subset:  IM    
Michigan State University, East Lansing, USA.
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MeSH Terms
Evidence-Based Medicine*
Philosophy, Medical*
United States
Erratum In:
Soc Sci Med. 2011 Dec;73(12):1782

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

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