Evidence based medicine: a critical inquiry. Seminar Lecture

• Evidence-based medicine and practice (EBM/EBP) have since their inception in the early 1990s had widespread impact on the teaching and practice of medicine and health care. While the western societies are becoming more postmodernist, the medical system remains increasingly modernist in its outlook, this may make it increasingly irrelevant to the needs of a changing society. However, criticism is essentially a changing process of our realities. Hence, the prominence given to EBM can not be seen as a solely attempt to reassert modernism within the field, but as an improved paradigm reviewing itself in lights of challenges it faces. Relevant to my topic here is that the debate, which took sometimes, unfortunately, metaphorical and aggressive directions, has contributing effect on both the EBM and its critics moderating both methodologies and epistemes especially the introducing of other kinds of researches, than randomized controlled trails (RCT), systematic reviews or meta-analysis of RCTs, like user-led research and qualitative researches which focus on personal experience of both the patient and clinician. In the developing countries there are many challenges, whether technical, social or epistemological, facing practicing and using them. Although few Arab countries have recently developed either centers or associations for EBM, Iraq still lacks such kind of practice. Presenting an outlook of EMB from within the current intellectual debate and examining the environment and essential aspects of this debate between the EMB and its postmodernist critics might be helpful in not a merely dogmatic promotion of its practice nor a blind call for adopting and applying its guidelines and techniques but in enforcing the discussion and dialogue between the current disputable paradigms in the one hand and improve the possibilities and resources to use it as the “best” paradigm in medical practices and education. A conclusion has drawn on here that EBM paradigm does not only improve the decision-making in health services and provides a serious attempt to invent a new language that might reunite the Babel of doctors and patients, managers and consumers, but also it understands medical care in both the closed and open systems. Epistemological, methodological, ethical and social questions about the patient/subject are addressed here aiming to encourage the health and educational authorities in Iraq to take this paradigm seriously and introduce it in their future programs.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Annan hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Other Health Sciences (hsv//eng)

Keyword

EBM

Publication and Content Type

vet (subject category)

kon (subject category)