Evidence based medicine guidelines: a solution to rationing or politics disguised as science?

“Evidence based medicine” (EBM) is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the pers...

Full description

Saved in:
Bibliographic Details
Published in:Journal of medical ethics 2004-04, Vol.30 (2), p.171-175
Main Authors: Saarni, S I, Gylling, H A
Format: Article
Language:English
Subjects:
Bioethics
Clinical medicine
Costs and Cost Analysis - ethics
Empirical evidence
Epistemology
Evidence based medicine
Evidence-Based Medicine - economics
Evidence-Based Medicine - ethics
guidelines
Health care expenditures
Health Care Rationing - economics
Health Care Rationing - ethics
Health outcomes
Humans
Managed care
Medical ethics
Medical practice
medical professionalism
Medical research
Medicine
Philosophy, Medical
Physicians
Politics
Practice Guidelines as Topic
Professionalism
Public health
Public Health - ethics
Quality of Health Care - ethics
Randomized Controlled Trials as Topic - ethics
Rationing
Research Design
Symposium on Evidence Based Medicine
Trends
Uncertainty
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:“Evidence based medicine” (EBM) is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the perspective of individual patients, doctors, or public health administrators. Evidence based medicine exerts a fundamental influence on certain key aspects of medical professionalism. Since, when clinical practice guidelines are created, costs affect the content of EBM, EBM inevitably becomes a form of rationing and adopts a public health point of view. This challenges traditional professionalism in much the same way as managed care has done in the US. Here we chart some of these major philosophical issues and show why simple solutions cannot be found. The profession needs to pay more attention to different uses of EBM in order to preserve the good aspects of professionalism.
ISSN:0306-6800
1473-4257
DOI:10.1136/jme.2003.003145