David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jonathan Jenkins Ichikawa
Jack Alan Reynolds
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Medicine, Health Care and Philosophy 5 (3):273-280 (2002)
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
|Keywords||clinical experience clinical freedom clinical judgement clinical practice guidelines clinical wisdom evidence-based medicine meaning narrative phronesis postmodernism|
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Citations of this work BETA
Malcolm Parker (2007). Two Into One Won't Go: Conceptual, Clinical, Ethical and Legal Impedimenta to the Convergence of Cam and Orthodox Medicine. [REVIEW] Journal of Bioethical Inquiry 4 (1):7-19.
Ricca Edmondson & Jane Pearce (2007). The Practice of Health Care: Wisdom as a Model. [REVIEW] Medicine, Health Care and Philosophy 10 (3):233-244.
Malcolm Parker (2007). Rejoinder. Journal of Bioethical Inquiry 4 (1):29-31.
David Wasserman (2011). Is Racial Profiling More Benign in Medicine Than Law Enforcement? Journal of Ethics 15 (1/2):119 - 129.
Sabine Salloch (forthcoming). Who’s Afraid of EBM? Medical Professionalism From the Perspective of Evidence-Based Medicine. Medicine, Health Care and Philosophy.
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