Is Evidence-based Medicine positivist?

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Brian Walsh
Grant Gillett


Aim: This paper aims to examine whether Evidence-based Medicine (EBM) is positivist and to consider the implications of the answer.Method The initial announcement of EBM in 1992 is used to ascertainthe philosophy of EBM.  The definition of  positivism is taken from Ian Hacking. The paper draws on Greavesfor a discussion of whether medicine can be concentrated into a positivistic model. Particular attention is given to a landmark paper on EBM philosophy published in 2009.Results: The defence against the charge of positivism is noted.  Even so, it is concluded that EBM is positivist.  It emphasises observation, verification and method over theory.  Yet allopathy distinguishes itself from complementary and alternative approaches to healing by holding to scientific theory.Conclusion: EBM is positivist.  In consequence, EBM is too limited to be synonymous with or quivalent to good medicine or singulary to inform an effective health care, which involves many dimensions, including interpersonal/social and philosophical dimensions.  EBM gives no account of symbolism in medicine.  Complaining about lack of attention to the evidence, it scarcely adjusts the ideal medical model to what doctors actually use, where there is less certainty and control over variables.

Article Details

Regular Articles
Author Biography

Grant Gillett

Division of Health Sciences, University of Otago, Dunedin, New Zealand.


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