A return to reasonableness and virtue in medical epistemology.

Abstract:

:The foundationalist and anti-foundationalist conceptions of medical knowledge have been at loggerheads for decades. Evidence-based medicine (EBM), the most prominent form of foundationalism, has attained wide appeal and acceptance among authorities. It proposes that evidence is the "base" upon which all clinical decisions should be grounded. Others have countered that the clinical encounter is far too complex for a singular base, and the different factors that impose on a clinical decision cannot be neatly and permanently ranked a priori. By its very nature, this anti-foundationalist outlook has resisted simplistic description, which is perhaps the reason it has not been as popular. In this paper, I provide a survey of the foundationalist and anti-foundationalist debate in medicine and defend anti-foundationalism on the basis that foundationalist approaches are anachronistic, and in the case of evidence-based medicine ultimately confuses inputs (evidence) for consideration in making a judgement with outputs (conclusions). I further propose that virtue ethics is inseparable from anti-foundationalism and conclude that the current infatuation with EBM implies something rather troubling; that physicians cannot be trusted to utilize their extensive training and skills to make reasonable decisions in the best interests of their patients. If this is in fact true, it suggests a crisis in virtue amongst medical professionals.

journal_name

J Eval Clin Pract

authors

Ghinea N

doi

10.1111/jep.13273

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

447-451

issue

2

eissn

1356-1294

issn

1365-2753

journal_volume

26

pub_type

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