Evidence-Based Medicine (EBM): The (Only) Means for Distinguishing Knowledge of Medical Causation from Expert Opinion in the Courtroom
Christopher P. Guzelian
Thomas Jefferson School of Law
Terence M. Davidson
University of California, San Diego (UCSD) - School of Medicine
Tort Trial & Insurance Practice Law Journal, Vol. 47, No. 2, Winter 2012
Thomas Jefferson School of Law Research Paper
Evidence-based medicine (EBM) was first established in the 1980s when physicians and medical educators purposed to more uniformly apply standards of evidence gained from the scientific method to assess questions of medical causation. Now widely employed by physicians in medical decision making and during their selections of medical treatment, and nearly omnipresent in modern medical student education, EBM allows doctors to separate scientific facts from opinions in determining clinical treatment efficacy. Accordingly, EBM — whether in a hospital or in a courtroom — is the systematic method capable of distinguishing expert pronouncements about medical or scientific questions of causation as either (1) authority-based opinions (derived from expert intuition or reasoning, principles of pathophysiology, or inference based on experimental or observational data of insufficient quality) or (2) evidence-based conclusions (objective knowledge arising from the availability of sufficient, high-quality evidence).
This article recommends that EBM should supplement ineffective legal gatekeeper rules of scientific evidence and be incorporated into the courtroom to (1) accurately distinguish medical knowledge from mere expert opinion and (2) thereby assist the court in correctly adjudicating disputed medical matters and toxic industrial or environmental exposure cases.
Number of Pages in PDF File: 40
Keywords: Evidence-Based Medicine, EBM, scientific evidence, medical malpractice, environmental
JEL Classification: K13, K32, K41Accepted Paper Series
Date posted: October 30, 2012
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