A critical appraisal of evidence‐based medicine: some ethical considerations
Abstract
Evidence‐based medicine (EBM) is a concept that has grown to dominate the medical literature over the last decade. EBM has provoked a variety of criticisms, scientific, philosophical and sociological. However, while its basic conclusion – that we should practise EBM – is ethical, there has been limited ethical analysis of EBM. This paper aims to provide an analysis of EBM from an ethical perspective and identify some of EBM's potential ethical implications. Following a description of what constitutes EBM, this paper will identify and assess some of the basic values and epistemological assumptions of EBM that provide support for the moral duty to practise EBM. It will then examine potential ethical implications that could arise from practising EBM, given the challenges that have been made of EBM's assumptions and claims to authority. This paper will conclude by arguing that practitioners could strengthen the ethics of EBM by embracing a broader definition of evidence and including ethical criteria in the critical appraisal of research studies.
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Policy makers can be subject to non-rational decision influences.
“Satisficing alternatives may be subject to a number of diverse influences, which support the position that policy makers can be subject to non-rational decision influences [13,25,41,47,51-53].”
From Rationality versus reality: the challenges of evidence-based decision making for health policy makers (2010) · cites this paper as [51]
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- Authors
- Gupta, M.
- Affiliations
- McMaster University (CA)
- Corresponding author
- Gupta, M.
- ORCID
- Gupta, M.
- Venue
- Journal of Evaluation in Clinical Practice
- Publisher
- Wiley
- Published
- 2003-05
- Volume
- 9
- Issue
- 2
- Pages
- 111-121
- ISSN
- 1356-1294 (ISSN-L)
- 1365-2753
- OpenAlex
- W1955527663
- Cited by
- 116
- References
- 42
- Citations by year
- 2025: 5 · 2024: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 4 · 2017: 1 · 2016: 6 · 2015: 1 · 2014: 6 · 2013: 5 · 2012: 4
- FWCI
- 29.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Evaluation in Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- evidence-based medicine, medical ethics, critical appraisal, epistemological assumptions, moral obligation, definition of evidence
- MeSH terms
- Decision Making, Delivery of Health Care, Health Services Research, Humans, Morals, Research Design, Research Support as Topic, Social Values, Bias, Evidence-Based Medicine, Knowledge, Biomedical Research
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