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Fundamental shortcomings of evidence‐based medicine

Fundamental shortcomings of evidence‐based medicine The development of any scientific theory has a certain logic. Bruno Latour formulated a theory, describing the development of science and technology. Outcomes of science are not guided by nature or “the truth”, but by a complex negotiation. It starts with ideas, which follow paths of publications and assessment. Then they are either rejected or accepted. Analysing the development of evidence‐based medicine with Latour's theory, we find two fundamental problems. First, EBM tends to standardise moral considerations. Second, EBM standardises the patient, since test populations are usually composed homogeneously. Presumptions concerning methods and morals are slid into the EBM‐methodology during its development. With Latour we should say, that the conceptions of the standard patient and standard morals have been delegated to this methodology. They are carried out strictly, and this causes the discomfort with practitioners and scientists within EBM. A solution should be sought for in redesigning trials, in a less morally charged fashion, and concerning less standardised patients. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Health Organisation and Management Emerald Publishing

Fundamental shortcomings of evidence‐based medicine

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Publisher
Emerald Publishing
Copyright
Copyright © 2003 MCB UP Ltd. All rights reserved.
ISSN
1477-7266
DOI
10.1108/14777260310506614
pmid
14730800
Publisher site
See Article on Publisher Site

Abstract

The development of any scientific theory has a certain logic. Bruno Latour formulated a theory, describing the development of science and technology. Outcomes of science are not guided by nature or “the truth”, but by a complex negotiation. It starts with ideas, which follow paths of publications and assessment. Then they are either rejected or accepted. Analysing the development of evidence‐based medicine with Latour's theory, we find two fundamental problems. First, EBM tends to standardise moral considerations. Second, EBM standardises the patient, since test populations are usually composed homogeneously. Presumptions concerning methods and morals are slid into the EBM‐methodology during its development. With Latour we should say, that the conceptions of the standard patient and standard morals have been delegated to this methodology. They are carried out strictly, and this causes the discomfort with practitioners and scientists within EBM. A solution should be sought for in redesigning trials, in a less morally charged fashion, and concerning less standardised patients.

Journal

Journal of Health Organisation and Management – Emerald Publishing

Published: Dec 1, 2003

Keywords: Medicines; Philosophy; Medical sciences

References

  • Schaatsen op dik ijs – Evidence‐based Medicine in de praktijk