David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jack Alan Reynolds
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Perspectives in Biology and Medicine 52 (2):168-187 (2009)
Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid hierarchy of evidence as the culprit of its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. -/- .
|Keywords||Evidence Evidence-based medicine philosophy of medicine medical epistemology|
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Citations of this work BETA
Jonathan Fuller (2013). Rhetoric and Argumentation: How Clinical Practice Guidelines Think. Journal of Evaluation in Clinical Practice 19 (3):433-441.
Luis Flores (2015). Therapeutic Inferences for Individual Patients. Journal of Evaluation in Clinical Practice 21 (3):440-447.
Mark R. Tonelli (2009). A Late and Shifting Foundation: A Commentary on Djulbegovic, B., Guyatt, G. H. & Ashcroft, R. E. (2009) Cancer Control, 16, 158–168. [REVIEW] Journal of Evaluation in Clinical Practice 15 (6):907-909.
Joachim P. Sturmberg (2009). EBM: A Narrow and Obsessive Methodology That Fails to Meet the Knowledge Needs of a Complex Adaptive Clinical World: A Commentary on Djulbegovic, B., Guyatt, G. H. & Ashcroft, R. E. (2009) Cancer Control, 16, 158–168. [REVIEW] Journal of Evaluation in Clinical Practice 15 (6):917-923.
Shashi S. Seshia, Michael Makhinson & G. Bryan Young (2014). Evidence-Informed Person-Centred Health Care : Are ‘Cognitive Biases Plus’ Underlying the EBM Paradigm Responsible for Undermining the Quality of Evidence? Journal of Evaluation in Clinical Practice 20 (6):748-758.
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