Evidence-based medicine and epistemological imperialism: narrowing the divide between evidence and illness

Authors

  • Helen Crowther BSc MBBS(Hons) FRACP FRCPA,

    1. Clinical Superintendent, Department of Medicine, Westmead Hospital, Sydney, New South Wales, Australia and Doctoral Scholar, Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
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  • Wendy Lipworth BSc(Med)Hons MBBS MSc PhD,

    1. Postdoctoral Researcher, Australian Institute of Health Innovation, University of New South Wales, Sydney, New South Wales, Australia and Affiliate, Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
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  • Ian Kerridge BA BMed(Hons) MPhil (Cantab) FRACP FRCPA

    Corresponding author
    1. Associate Professor, Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
      Associate Professor Ian Kerridge, Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW 2006, Australia. E-mail: ian.kerridge@sydney.edu.au
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Associate Professor Ian Kerridge, Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW 2006, Australia. E-mail: ian.kerridge@sydney.edu.au

Abstract

Evidence-based medicine (EBM) has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the evidence we have about disease and its treatment. This creates a significant ethical, epistemological and ontological challenge for medicine.

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