Ethics and Evidence-Based Medicine: Fallibility and Responsibility in Clinical Science

The growth of evidence-based medicine has occurred against a backdrop of health care reform, managed care, cost containment and quality improvement, and clinicians have been urged to adopt the rigours of science while remaining true to their ‘clinical judgement’. This tension - between efforts to make medical practice more scientific and the suspicions of many clinicians - has caused one of the greatest practical and ethical challenges in the history of the health professions. This incisive book reviews the history and conceptual origins of evidence-based practice, and discusses key ethical issues that arise in clinical practice, public health and health policy. Essential reading for all physicians, and practitioners in epidemiology and public health, it will also be suitable as a text in medical and public health school courses on evidence-based practice.

• On ethics and evidence-based medicine • Addresses clinical application of systematic reviews and other research syntheses • Analyses the debate between ‘art’ and ‘science’ of health practice

Preface; Acknowledgements; 1. Foundations and history of evidence-based practice; 2. The research synthesis revolution; 3. Evidence of evidence, and other conceptual challenges; 4. Human subjects, the internet, databases and data mining; 5. Evidence at the bedside; 6. Public health policy, uncertainty and genetics; 7. Ethics and evidence; References; Index.