Whither our art? Clinical wisdom and evidence-based medicine

Medicine, Health Care and Philosophy 5 (3):273-280 (2002)
  Copy   BIBTEX

Abstract

The relationship between evidence-based medicine (EBM) and clinical judgement is the subject of conceptual and practical dispute. For example, EBM and clinical guidelines are seen to increasingly dominate medical decision-making at the expense of other, human elements, and to threaten the art of medicine. Clinical wisdom always remains open to question. We want to know why particular beliefs are held, and the epistemological status of claims based in wisdom or experience. The paper critically appraises a number of claims and distinctions, and attempts to clarify the connections between EBM, clinical experience and judgement, and the objective and evaluative categories of medicine. I conclude that to demystify clinical wisdom is not to devalue it. EBM ought not be conceived as needing to be limited or balanced by clinical wisdom, since if its language is translatable into terms comprehensible and applicable to individuals, it helps constitute clinical wisdom. Failure to appreciate this constitutive relation will help perpetuate medical paternalism and delay the adoption of properly evidence-based practice, which would be both unethical and unwise

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 74,247

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Mechanisms: What Are They Evidence for in Evidence-Based Medicine?Holly Andersen - 2012 - Journal of Evaluation in Clinical Practice 18 (5):992-999.
The Philosophy of Evidence-Based Medicine.Jeremy Howick - 2011 - Wiley-Blackwell, Bmj Books.
Evidence-Based Medicine Must Be ..A. La Caze - 2009 - Journal of Medicine and Philosophy 34 (5):509-527.
Does Evidence-Based Medicine Apply to Psychiatry?Mona Gupta - 2007 - Theoretical Medicine and Bioethics 28 (2):103.
Evidence‐Based Medicine Can’T Be….Adam La Caze - 2008 - Social Epistemology 22 (4):353 – 370.
Recognizing Tacit Knowledge in Medical Epistemology.Stephen G. Henry - 2006 - Theoretical Medicine and Bioethics 27 (3):187--213.
Clinical Reasoning: New Challenges.William E. Stempsey - 2009 - Theoretical Medicine and Bioethics 30 (3):173-179.
The Role of Basic Science in Evidence-Based Medicine.Adam La Caze - 2011 - Biology and Philosophy 26 (1):81-98.
Argumentation and Evidence.R. E. G. Upshur & Errol Colak - 2003 - Theoretical Medicine and Bioethics 24 (4):283-299.

Analytics

Added to PP
2010-08-31

Downloads
52 (#223,659)

6 months
1 (#415,205)

Historical graph of downloads
How can I increase my downloads?

Author's Profile

References found in this work

The Last Word.Thomas Nagel - 1997 - Oxford: Oxford University Press.
The Last Word.Thomas Nagel - 1999 - Philosophical Quarterly 49 (197):529-536.
Evidence Based Medicine and Ethics.T. Hope - 1995 - Journal of Medical Ethics 21 (5):259-260.
Kant.Roger Scruton - 1983 - In German Philosophers. Oxford University Press.
Evidence and Clinical Judgement.R. Jane Macnaughton - 1998 - Journal of Evaluation in Clinical Practice 4 (2):89-92.

View all 9 references / Add more references