The Politics of Evidence-Based Medicine
8 Pages Posted: 11 Sep 2007
In this essay I argue that rational evaluation of evidence plays an important role in medicine, but that it is not an alternative to medical politics. Rather, evidence is a tool for institutional control and policy argument. Today evidence-based medicine is used to oversee individual physicians and the practice of medicine. It thus helps to alter the balance of power among doctors, payers, and patients. Changing medical practice requires the development of political, legal, and medical institutions that oversee medical care. Promoting medical practice based on evidence will therefore necessitate more, not less politics. The essay explores the political significance of the evidence-based medicine movement, the politics of expertise and evidence in policy debates, and the role of courts, and the relation between evidence and accountability.
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