A discussion on the future of evidence-based Medicine.
Written in 2005; 2,145 words; 19 sources; APA; $ 67.95
Paper Summary:
This paper discusses the issue of evidence-based Medicine (EBM), providing arguments for and against it being abandoned altogether. The author of this paper puts forward his own suggestion that the real question is not whether EBM should be destroyed or sustained, but what it should look like a cathedral or a bazaar? He goes on to argue that, if EBM is to serve the interests of service users as much as those of the medical and pharmaceutical powers, it must come to resemble a bazaar more than a cathedral.
From the Paper:
"Some critics of Evidence Based Medicine (EBM) argue that it should be abandoned altogether (e.g. Sa Couta 2003). By contrast, Sandra Tanenbaum (2003, p. 298) argues that, despite its weaknesses in practice, the public idea of EBM lends it a power that can be used by health administrators to support policy decisions that can benefit patients. A key problem with Tanenbaum's approach is that it underestimates the role of ideas in shaping social practice and the extent to which the philosophy of EBM has come to serve particular commercial and ideological interests. I would suggest that the future of health services research lies not in destroying or preserving the idea of EBM but in questioning and subverting it. The real question is not whether EBM should be destroyed or sustained, but what it should look like: a Cathedral or a Bazaar? One type of structure represents hierarchy, order, authority, exclusion and the pious realisation of a complex but unitary concept. The other represents a 'great babbling bazaar of different agendas and approaches' (Raymond 2000, p. 1), potentially profane and subversive, but nonetheless inclusive in character. I want to argue that the movement that embodies the idea of EBM must be subverted from within. If it is to serve the interests of service users as much as those of medical and pharmaceutical power it must come to resemble a Bazaar more than a Cathedral."
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