David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
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
Maya J. Goldenberg (2010). From Popperian Science to Normal Science. Commentary on Sestini (2009) 'Epistemology and Ethics of Evidence‐Based Medicine'. Journal of Evaluation in Clinical Practice 16 (2):306-309.
Jonathan Fuller (2013). Rhetoric and Argumentation: How Clinical Practice Guidelines Think. Journal of Evaluation in Clinical Practice 19 (3):433-441.
Leah M. McClimans & John Browne (2011). Choosing a Patient-Reported Outcome Measure. Theoretical Medicine and Bioethics 32 (1):47-60.
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.
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