14 found
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Mark R. Tonelli
University of Washington
  1.  76
    Integrating evidence into clinical practice: an alternative to evidence‐based approaches.Mark R. Tonelli - 2006 - Journal of Evaluation in Clinical Practice 12 (3):248-256.
    Evidence-based medicine (EBM) has thus far failed to adequately account for the appropriate incorporation of other potential warrants for medical decision making into clinical practice. In particular, EBM has struggled with the value and integration of other kinds of medical knowledge, such as those derived from clinical experience or based on pathophysiologic rationale. The general priority given to empirical evidence derived from clinical research in all EBM approaches is not epistemically tenable. A casuistic alternative to EBM approaches recognizes that five (...)
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  2.  59
    The challenge of evidence in clinical medicine.Mark R. Tonelli - 2010 - Journal of Evaluation in Clinical Practice 16 (2):384-389.
  3.  62
    A late and shifting foundation: a commentary on Djulbegovic, B., Guyatt, G. H. & Ashcroft, R. E. (2009) Cancer Control, 16, 158–168. [REVIEW]Mark R. Tonelli - 2009 - Journal of Evaluation in Clinical Practice 15 (6):907-909.
  4.  42
    Advancing a casuistic model of clinical decision making: a response to commentators.Mark R. Tonelli - 2007 - Journal of Evaluation in Clinical Practice 13 (4):504-507.
  5.  52
    Substituted Judgment in Medical Practice: Evidentiary Standards on a Sliding Scale.Mark R. Tonelli - 1997 - Journal of Law, Medicine and Ethics 25 (1):22-29.
    Consensus is growing among ethicists and lawyers that medical decision making for incompetent patients who were previously competent should be made in accordance with that person's prior wishes and desires. Moreover, this legal and ethical preference for the substituted judgment standard has found its way into the daily practice of medicine. However, what appears on the surface to be an agreement between jurists, bioethicists, and clinicians obscures the very real differences between disciplines regarding the actual implementation of the sub stituted (...)
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  6.  46
    Compellingness: assessing the practical relevance of clinical research results.Mark R. Tonelli - 2012 - Journal of Evaluation in Clinical Practice 18 (5):962-967.
  7.  56
    Not a philosophy of clinical medicine: a commentary on 'The Philosophy of Evidence‐based Medicine' Howick, J. ed. (2001).Mark R. Tonelli - 2011 - Journal of Evaluation in Clinical Practice 17 (5):1013-1017.
  8.  44
    Experiential knowledge in clinical medicine: use and justification.Mark R. Tonelli & Devora Shapiro - 2020 - Theoretical Medicine and Bioethics 41 (2):67-82.
    Within the evidence-based medicine construct, clinical expertise is acknowledged to be both derived from primary experience and necessary for optimal medical practice. Primary experience in medical practice, however, remains undervalued. Clinicians’ primary experience tends to be dismissed by EBM as unsystematic or anecdotal, a source of bias rather than knowledge, never serving as the “best” evidence to support a clinical decision. The position that clinical expertise is necessary but that primary experience is untrustworthy in clinical decision-making is epistemically incoherent. Here (...)
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  9.  5
    Supporting Real-Time Ethical Deliberation in Contingency Capacity During the COVID-19 Pandemic.Mark R. Tonelli & Catherine R. Butler - 2021 - American Journal of Bioethics 21 (8):25-27.
    The reality of resource limitation during the Coronavirus Disease 2019 pandemic has deeply challenged established approaches to healthcare system emergency response. Early preparation du...
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  10.  27
    Mechanisms in clinical practice: use and justification.Mark R. Tonelli & Jon Williamson - 2020 - Medicine, Health Care and Philosophy 23 (1):115-124.
    While the importance of mechanisms in determining causality in medicine is currently the subject of active debate, the role of mechanistic reasoning in clinical practice has received far less attention. In this paper we look at this question in the context of the treatment of a particular individual, and argue that evidence of mechanisms is indeed key to various aspects of clinical practice, including assessing population-level research reports, diagnostic as well as therapeutic decision making, and the assessment of treatment effects. (...)
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  11.  76
    What medical futility means to clinicians.Mark R. Tonelli - 2007 - HEC Forum 19 (1):83-93.
  12.  1
    Too Much Ethics, Not Enough Medicine: Clarifying the Role of Clinical Expertise for the Clinical Ethics Consultant.Mark R. Tonelli & Clarence H. Braddock Iii - 2001 - Journal of Clinical Ethics 12 (1):24-30.
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  13.  30
    Evidence, through the looking glass. Commentary on Devisch and Murray (2009) 'We hold these truths to be self‐evident': deconstructing 'evidence‐based' medical practice.Mark R. Tonelli - 2009 - Journal of Evaluation in Clinical Practice 15 (6):955-956.
  14.  30
    Care of an Unresponsive Patient with a Poor Prognosis.Arthur S. Slutsky, Leonard D. Hudson, Nancy N. Dubler, Charles Weijer & Mark R. Tonelli - unknown