Epistemological and ethical issues of evidence-based concept in medicine
- Authors: Komlev A.E.1
-
Affiliations:
- National Medical Research Center of cardiology named after acad. E.I. Chazov
- Issue: Vol 17, No 2 (2024)
- Pages: 7-15
- Section: Theoretical bioethics
- URL: https://journals.rcsi.science/2070-1586/article/view/272342
- DOI: https://doi.org/10.19163/2070-1586-2024-17-2-7-15
- ID: 272342
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Abstract
Despite of active implementation of the concept of “evidence-based medicine” into all areas of medical education, clinical science and practical healthcare, the epistemological problems of this new scientific reality currently remain underdeveloped in the philosophy of science.
Aim: to identify the epistemological and ethical problems inherent in the evidence-based approach in medicine.
Methods: The epistemological and ethical aspects of the concept of evidence-based medicine were considered.
Results: At the current stage, evidence-based medicine reflects a transitional stage from the classical to the non-classical research paradigm. In this regard, the epistemological and ethical aspects of the concept of evidence-based medicine require further study and critical reflection.
Conclusions: The discourse of evidence adopted in medicine today is aimed at increasing the objectivity of medical knowledge from practical point of view. However, this approach is not without significant drawbacks, including the overestimation of statistical patterns at the expense of “individual clinical differences”, the implicit primacy of phenomenological settings over the theoretical layer in the postulated structure of the scientific program, the unjustifiably rapid doctrinalization of the approach and the stigmatization of its opponents.
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##article.viewOnOriginalSite##About the authors
Alexey E. Komlev
National Medical Research Center of cardiology named after acad. E.I. Chazov
Author for correspondence.
Email: pentatonika@bk.ru
ORCID iD: 0000-0002-5736-5698
SPIN-code: 5558-7440
Scopus Author ID: 18634465200
ResearcherId: AAB-3149-2021
Cardiologist of the Department of Cardiovascular Surgery
Russian Federation, MoscowReferences
- Foundations of evidence-based medicine. Textbook for the system of postgraduate and additional professional education of doctors. Under the general editorship of Academician RAMS, Professor R.G. Oganov. Moscow, 2010. (in Rus.).
- Ugleva A. Intellectual Virtue and the Epistemological Nature of Medical Evidence. Filosofiya. Zhurnal Vysshei shkoly ekonomiki = Philosophy Journal of the Higher School of Economics. 2021;5(4):138–156. (in Rus.) doi: 10.17323/2587-8719-2021-4-138-156.
- Grigoryev S.G., Evdokimov V.I. Evidence-based medicine: methodology and current situation. Mediko-biologicheskie i sotsial'no-psikhologicheskie problemy bezopasnosti v chrezvychainykh situatsiyakh = Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2008; 3:59–69. (in Rus.).
- Averkina E.I. Humanitarian space of medical discourse. Filosofskie nauki = Russian journal of philosophical sciences. 2014;12:103–110. (in Rus.).
- Mendelevich V.D. Psychopharmacotherapy ethics in the era of evidence-based medicine. Prakticheskaya meditsina = Practical Medicine. 2019;17(3);19–22. (in Rus.) doi: 10.32000/2072-1757-2019-3-19-22.
- Kulikov V.A. Fremingham Heart Study: 65 years of studying the causes of atherosclerosis. Vestnik Vitebskogo gosudarstvennogo meditsinskogo universiteta = Vitebsk medical journal. 2012;11(2);16–24. (in Rus.).
- Ashcroft R.E. Current Epistemological Problems in Evidence Based Medicine. Journal of Medical Ethics. 2004; 30:135. doi: 10.1136/jme.2003.007039.
- Fernandez A., Sturmberg J., Lukersmith S. et al. Evi-dence-based medicine: is it a bridge too far? Health Research Policy and Systems. 2015;13:66. doi: 10.1186/s12961-015-0057-0.
- Lakatos I. Falsification and the methodology of scientific research programmes. Cambridge University Press, 1970.
- On pseudoscience of homeopathy: Memorandum No. 2 of the RAS Commission on combating pseudoscience and falsification of scientific research. 07.02.2017. (in Rus.) URL: http://klnran.ru/2017/02/memorandum02-homeopathy (accessed: 08.01.2024).
- Horwitz R.I., Singer B.H. Why evidence-based medicine failed in patient care and medicine-based evidence will succeed. Journal of Clinical Epidemiology. 2017;84:14–17. doi: 10.1016/j.jclinepi.2017.02.003.
- Horwitz R.I., Charlson M.E., Singer B.H. Medicine based evidence and personalized care of patients. European Journal of Clinical Investigation. 2018;48(7):E12945. doi: 10.1111/eci.12945.
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