Evidence based medicine guidelines: a solution to rationing or politics disguised as science?

Journal of Medical Ethics 30 (2):171-175 (2004)
“Evidence based medicine” is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the perspective of individual patients, doctors, or public health administrators. Evidence based medicine exerts a fundamental influence on certain key aspects of medical professionalism. Since, when clinical practice guidelines are created, costs affect the content of EBM, EBM inevitably becomes a form of rationing and adopts a public health point of view. This challenges traditional professionalism in much the same way as managed care has done in the US. Here we chart some of these major philosophical issues and show why simple solutions cannot be found. The profession needs to pay more attention to different uses of EBM in order to preserve the good aspects of professionalism
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1136/jme.2003.003145
 Save to my reading list
Follow the author(s)
My bibliography
Export citation
Find it on Scholar
Edit this record
Mark as duplicate
Revision history Request removal from index
Download options
PhilPapers Archive

Upload a copy of this paper     Check publisher's policy on self-archival     Papers currently archived: 16,667
External links
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.

Add more references

Citations of this work BETA
Stephen G. Henry (2006). Recognizing Tacit Knowledge in Medical Epistemology. Theoretical Medicine and Bioethics 27 (3):187--213.

View all 6 citations / Add more citations

Similar books and articles
Mark A. Hall (1994). The Problems with Rule-Based Rationing. Journal of Medicine and Philosophy 19 (4):315-332.
John Worrall (2010). Evidence: Philosophy of Science Meets Medicine. Journal of Evaluation in Clinical Practice 16 (2):356-362.
Erica Zarkovich & R. E. G. Upshur (2002). The Virtues of Evidence. Theoretical Medicine and Bioethics 23 (4-5):403-412.

Monthly downloads

Added to index


Total downloads

3 ( #483,044 of 1,727,257 )

Recent downloads (6 months)

2 ( #289,836 of 1,727,257 )

How can I increase my downloads?

My notes
Sign in to use this feature

Start a new thread
There  are no threads in this forum
Nothing in this forum yet.