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Broad Medical Uncertainty and the ethical obligation for openness
Rebecca C H Brown1, Mícheál de Barra2, Brian D Earp1
1Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK.
Synthese
|April 18, 2022
Summary
Many medical treatments face Broad Medical Uncertainty (BMU) due to research flaws and biased practices. Openness about this uncertainty is ethically crucial, despite concerns about trust in healthcare.
Area of Science:
- Medical Research Methodology
- Evidence-Based Practice
- Healthcare Ethics
Background:
- A significant degree of uncertainty exists regarding the effectiveness of numerous medical interventions.
- Unduly optimistic beliefs about the benefit/harm profiles of medical treatments are prevalent.
Purpose of the Study:
- To define and describe the features of Broad Medical Uncertainty (BMU).
- To identify key factors contributing to BMU in medical research and practice.
- To advocate for an ethical approach to addressing BMU.
Main Methods:
- Conceptual analysis of medical research, publication, and evidence translation.
- Examination of factors contributing to uncertainty in medical evidence.
- Ethical argumentation for transparency in healthcare.
Main Results:
- Identified flaws in research, publication bias, conflicts of interest, and evidence translation issues as drivers of BMU.
- BMU leads to uncertainty about treatment effectiveness and skewed benefit/harm perceptions.
- Proposed an ethical presumption favoring openness about BMU ('Corrective Response').
Conclusions:
- The 'Corrective Response' advocates for transparency regarding BMU.
- Addressed objections, such as potential erosion of trust, arguing against the 'Anti-Corrective Response'.
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