Translating Evidence: The Curious History of the Word that Transformed Medicine

Evidence-Based Medicine (EBM) is arguably the dominant paradigm in medicine today. Most doctors across the globe will be familiar with the term, and many would consider it the bedrock of good clinical care. Yet, EBM has met with unexpected difficulties translating its aspirations globally. We focus on the word evidence as a key to understanding this problem. Following the trajectory of the word evidence in French and Spanish medicine as a case of untranslatability (Barbara Cassin), we argue that the troubles inherent in translating evidence across languages and cultures point back to the complexity and nonobviousness of the word in English. This complexity haunts EBM, and it should be centered, not obscured, in discussions about how to translate clinical research into medical practice. We conclude by encouraging medicine, first, to embrace these linguistic difficulties as a key to offering better care; second, to view the issues we raise not as solvable with the right word but as an intrinsic part of the languages themselves; and, finally, to use the difficulty and underacknowledged pluralism within the language of medicine as a provocation for thinking more broadly about how medical knowledge is made, understood, and circulated.