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If not evidence, then what? Or does medicine really need a base?
1Primary Care Unit, Sunnybrook and Women's College Health Sciences Centre. rupshur@idirect.com
Journal of Evaluation in Clinical Practice
|August 16, 2002
Summary
Evidence-based medicine (EBM) relies on a foundationalist base, but anti-foundationalist critiques highlight the need for multiple perspectives in healthcare. This analysis explores the concept of a
Area of Science:
- Philosophy of Medicine
- Epistemology
- Healthcare Ethics
Background:
- The concept of a 'base' is crucial in evidence-based medicine (EBM).
- The sufficiency of evidence as a foundation for healthcare is debated.
- Alternative foundations for medical practice are explored.
Purpose of the Study:
- To analyze the concept of 'base' within evidence-based medicine.
- To evaluate the adequacy of evidence as a foundation for healthcare.
- To discuss the necessity and potential candidates for a foundational base in medicine.
Main Methods:
- Philosophical analysis of EBM and its epistemological underpinnings.
- Examination of foundationalist and anti-foundationalist perspectives.
- Review of recent literature in the philosophy of science.
Main Results:
- EBM is epistemologically linked to foundationalism.
- Significant criticisms of EBM arise from anti-foundationalist viewpoints.
- Multiple perspectives are essential for understanding and practicing medicine.
Conclusions:
- Evidence alone may not form a sufficient base for healthcare.
- Anti-foundationalist critiques reveal limitations in EBM's current framework.
- A broader, multi-perspective approach is necessary for a robust understanding of medicine.