David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jack Alan Reynolds
Learn more about PhilPapers
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|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
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.
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.
Similar books and articles
Holly Andersen (2012). Mechanisms: What Are They Evidence for in Evidence-Based Medicine. Journal of Evaluation in Clinical Practice 18 (5):992-999.
Brian Hazelton Walsh (2010). The Spatialisation of Disease: Foucualt and Evidence-Based Medicine (Ebm). [REVIEW] Journal of Bioethical Inquiry 7 (1):31-42.
Hillel D. Braude (2009). Clinical Intuition Versus Statistics: Different Modes of Tacit Knowledge in Clinical Epidemiology and Evidence-Based Medicine. Theoretical Medicine and Bioethics 30 (3):181-198.
Peter C. Gøtzsche (2007). Rational Diagnosis and Treatment: Evidence-Based Clinical Decision-Making. J. Wiley.
Jeremy Howick (2011). The Philosophy of Evidence-Based Medicine. Wiley-Blackwell, Bmj Books.
Maya J. Goldenberg (2006). On Evidence and Evidence-Based Medicine: Lessons From the Philosophy of Science. Social Science and Medicine 62 (11):2621-2632.
Maya J. Goldenberg (2012). Innovating Medical Knowledge: Undestanding Evidence-Based Medicine as a Socio-Medical Phenomenon. In Nikolaos Sitaras (ed.), Evidence-Based Medicine: Closer to Patients or Scientists? InTech Open Science
A. la Caze (2009). Evidence-Based Medicine Must Be .. Journal of Medicine and Philosophy 34 (5):509-527.
Mona Gupta (2007). Does Evidence-Based Medicine Apply to Psychiatry? Theoretical Medicine and Bioethics 28 (2):103.
Adam La Caze (2008). Evidence-Based Medicine Can't Be…. Social Epistemology 22 (4):353 – 370.
Ron Morstyn (2010). How the Philosophy of Merleau- Ponty Can Help Us Understand the Gulf Between Clinical Experience and the Doctrine of Evidence-Based Psychotherapy. Australasian Psychiatry 18 ( 3):221–225.
Stephen G. Henry (2006). Recognizing Tacit Knowledge in Medical Epistemology. Theoretical Medicine and Bioethics 27 (3):187--213.
William E. Stempsey (2009). Clinical Reasoning: New Challenges. Theoretical Medicine and Bioethics 30 (3):173-179.
Adam la Caze (2011). The Role of Basic Science in Evidence-Based Medicine. Biology and Philosophy 26 (1):81-98.
R. E. G. Upshur & Errol Colak (2003). Argumentation and Evidence. Theoretical Medicine and Bioethics 24 (4):283-299.
Added to index2010-08-31
Total downloads26 ( #154,390 of 1,911,506 )
Recent downloads (6 months)1 ( #457,144 of 1,911,506 )
How can I increase my downloads?