The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a
description that carries with it an enthusiasm for science that has not been seen since logical positivism ﬂourished (circa
1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one
suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the
apparent obviousness of EBM can and should be challenged on the grounds of how ‘evidence’ has been problematised in
the philosophy of science. EBM enthusiasm, it follows, ought to be tempered.
The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the
seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of
science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity
but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense
of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where
the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely
scientiﬁc should give pause.