David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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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
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Andrew Miles, Michael Loughlin & Andreas Polychronis (2008). Evidence‐Based Healthcare, Clinical Knowledge and the Rise of Personalised Medicine. Journal of Evaluation in Clinical Practice 14 (5):621-649.
Stephen G. Henry (2006). Recognizing Tacit Knowledge in Medical Epistemology. Theoretical Medicine and Bioethics 27 (3):187--213.
Monica Ortendahl (2008). Models Based on Value and Probability in Health Improve Shared Decision Making. Journal of Evaluation in Clinical Practice 14 (5):714-717.
Louise E. Parker, Mona J. Ritchie, JoAnn E. Kirchner & Richard R. Owen (2009). Balancing Health Care Evidence and Art to Meet Clinical Needs: Policymakers' Perspectives. Journal of Evaluation in Clinical Practice 15 (6):970-975.
Jesper Jerkert (2013). Jeremy Howick The Philosophy of Evidence‐Based Medicine.Wiley‐Blackwell & BMJ Books, 2011. Xiv + 229 Pp. ISBN 978‐1‐4051‐9667‐3 (Paperback). [REVIEW] Theoria 79 (2):180-186.
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