Implicit normativity in evidence-based medicine: a plea for integrated empirical ethics research

Area of Science:

• Bioethics
• Philosophy of Science
• Evidence-Based Medicine
• Integrated Empirical Ethics Research

Background:

• Traditional science distinguishes between descriptive (what is) and prescriptive (what ought to be) domains.
• Evidence-based medicine (EBM) relies on scientific facts for clinical decision-making.
• Patient autonomy is often linked to informed consent, assuming information disclosure is a prerequisite.

Purpose of the Study:

• To challenge the strict separation of descriptive and prescriptive sciences.
• To investigate the implicit normativity in the production and presentation of biomedical scientific facts.
• To explore the implications for bioethics, particularly integrated empirical ethics research and patient autonomy.

Main Methods:

• Interdisciplinary study analyzing the production and presentation of scientific information in EBM.
• Examination of implicit presuppositions and values embedded in evidence-based decision support tools.
• Conceptual analysis of implicit normativity within bioethical research.

Main Results:

• Biomedical scientific fact production and presentation contain implicit values and presuppositions.
• Evidence-based decision support not only aids but also morally transforms clinical decision-making.
• Patient autonomy is influenced during, not just after, information production and presentation.

Conclusions:

• The concept of implicit normativity is valuable for bioethics and integrated empirical ethics research.
• Increased responsibility is placed on scientists and physicians for the normativity in evidence they produce and present.
• Requires a broader scope of morality in bioethics and enhanced interdisciplinary cooperation between bioethicists and scientists.