Mugerauer, Robert. (2021). Professional Judgement in Clinical Practice (Part 1): Recovering Original, Moderate Evidence-Based Health Care. Journal Of Evaluation In Clinical Practice, 27(3), 592 – 602.
Abstract
Evidence-based medicine announced its entry as heralding a new paradigm in health care practices, but it has been widely criticized for lacking a coherent theoretical basis. This paper presents the first part of a three-article series examining the epistemological, practical, and ethical dimensions of strong EBM, as well as considering alternatives that promise potential solutions to chronic conceptual and practical problems. While the focus is on the details of the arguments and evidence in thoughtful debates over the last 30 years, it is worthwhile to keep in mind the overall trajectory of modern thought, because strong EBM continues discredited positivist positions, thus repeating its major assumptions and inadequacies, now transferred to the medical sphere and vocabulary. Part 1 of the series examines the development of strong EBM by clarifying and critiquing its somewhat discontinuous accounts of scientific knowledge and epistemology, evidence, the differences between statistical probability in regard to populations and understanding the health of individuals, and its claims for direct transfer of research findings to clinical settings-all of which raises more questions regarding its application to provider-patient decision making, pedagogy, and policy.
Keywords
Evidence-based Medicine; Theory Of Knowledge; Medical Ethics; Decision Making In Clinical Medicine; Policy Sciences; Clinical Practice; Epistemology; Ethics; Evidence; Evidence‚Äêbased Medicine; 2009 Cancer-control; Integrating Evidence; Decision-making; G. H.; Tonelli; Discourse; Knowledge; Ashcroft; Guyatt; Evidence‐ Based Medicine