Maya J. Goldenberg
University of Guelph
This paper examines the conclusions that one must draw from the finding that there are values in science. The value-ladenness of scientific claims puts the nature and role of empirical evidence into question, as seen in recent discussions in the philosophy of medicine regarding evidence-based medicine and feminist science studies, which maintains the normativity of its feminist claims. Within the critical literature and debates surrounding evidence-based medicine (EBM), one finds a championing of the lessons learned from post-positivist science studies: the evidence-based effort to ground medical decision-making in the most rigorous sources of scientific evidence obscures the social values that necessarily enter into all decision-making contexts, the complex social context of clinical practice being no exception. The critics of EBM claim that to try to derive a formal methodology governed by pre-established rules, guidelines, and hierarchies of information misplaces the contextual and social features of biomedical knowledge and practice, thereby obscuring the power interests that so problematically dictate large factions of biomedical research and practice. Yet possible relativist implications follow from this finding, and we find that the EBM critics amply criticize EBM’s tacit theory of evidence, but then fail to formulate a constructive alternative theory of evidence within this fact-value interplay. After overviewing some such criticisms of evidence-based medicine, I turn to contemporary critical science studies, especially the feminist empiricism of Lynn Hankinson Nelson and Helen Longino, for workable alternative theories of evidence within a framework of normative scientific claims. I will suggest these theories fail to guide medical decision-making because of some undesirable consequences of Quinean fact-value holism: the denial that our values have logical content and are therefore not empirically examinable relativises even these nuanced conceptions of evidence. A naturalized look at how facts and values actually interact in medical decision-making suggests that this fact/value holism is not realistic. I provide an illustrative example of a physician devising a treatment recommendation for a patient to demonstrate that in practice, facts and values intermingle in the decision-making process without indeterminacy and subsequent appeals to moral and political frameworks, as feminist empiricism suggests. In the end, value-laden evidence can retain its adjudicative force and normativity.
Keywords No keywords specified (fix it)
Categories (categorize this paper)
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 65,579
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

Add more citations

Similar books and articles

Evidence-Based Medicine: A New Tool for Resource Allocation?Rui Nunes - 2003 - Medicine, Health Care and Philosophy 6 (3):297-301.
The Role of Basic Science in Evidence-Based Medicine.Adam La Caze - 2011 - Biology and Philosophy 26 (1):81-98.
Evidence-Based Medicine Must Be ..A. La Caze - 2009 - Journal of Medicine and Philosophy 34 (5):509-527.
Whither Our Art? Clinical Wisdom and Evidence-Based Medicine.Malcolm Parker - 2002 - Medicine, Health Care and Philosophy 5 (3):273-280.
Clinical Evidence and the Absent Body in Medical Phenomenology.Maya J. Goldenberg - 2010 - International Journal of Feminist Approaches to Bioethiics 3 (1):43-71.
Evidence‐Based Medicine Can’T Be….Adam La Caze - 2008 - Social Epistemology 22 (4):353 – 370.


Added to PP index

Total views
42 ( #260,039 of 2,461,801 )

Recent downloads (6 months)
1 ( #448,803 of 2,461,801 )

How can I increase my downloads?


My notes