Iconoclast or Creed? Objectivism, pragmatism, and the hierarchy of evidence

Perspectives in Biology and Medicine 52 (2):168-187 (2009)
  Copy   BIBTEX


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.

Similar books and articles


Added to PP

1,835 (#4,403)

6 months
182 (#11,526)

Historical graph of downloads
How can I increase my downloads?

Author's Profile

Maya J. Goldenberg
University of Guelph

References found in this work

No references found.

Add more references