Reason, reality and objectivity – shared dogmas and distortions in the way both ‘scientistic’ and ‘postmodern’ commentators frame the EBM debate


Michael Loughlin
Department of Interdisciplinary Studies
Manchester Metropolitan University
Crewe CW1 5DU


Both defenders and certain critics of evidence-based medicine (EBM) share philosophical commitments – assumptions about the meaning of and relationship between such fundamental concepts as ‘objectivity’, ‘subjectivity’ and ‘rationality’– that frame the debate between them. Critics need to be particularly careful in analysing their own philosophical commitments. Ironically, failure to do so has led some to ground their rejection of EBM in philosophical theses that are less clear and/or more contentious than the reasonable conclusions they wish to defend. There is no need to label ‘objectivity’ a ‘myth’ or ‘scientific method’ an ‘illusion’ in order to identify what is wrong in EBM. Such strategies play into the hands of EBM dogmatists, allowing them to continue to position themselves as the defenders of ‘science’ and ‘reason’.