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Roy M. Poses MD
Brown University Center for Primary Care and Prevention
Memorial Hospital of RI
111 Brewster St.
Pawtucket, RI 02860
USA
401 729-2383
fax: 401 729-2494
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Actually, I hate to raise postmodernists in medicine, although not a vocal
bunch, have criticised EBM as being a metanarrative, a grand truth that
rests upon itself as being its own foundation and truth. They point out
that, while EBM approaches can make one practice more evidence-based, there
is little proof that evidence-based practice benefits patients in ways other
than making their practice more evidence-based. This circularity is the
major flaw, and reason for calling EBM a metanarrrative.
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>>>>
It would be interesting to see the references.
I don't think EBM is its own foundation. I think the foundation of EBM is
the notion that applying logical reasoning and the best scientific evidence
ought to produce optimal results in medicine and health care. This further
rests on the assumption that the scientific method is the best way to
find the best approximation of the truth, and further, of course, that there
is some sort of external truth or external reality.
I would love to see the postmodernist argument for how postmodernism benefits
patients, or anyone else ;-)
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Postmodernism thrives on deconstruction, like this. I think it useful,
because it conitnually makes one wonder "what if they (EBMers, CAMers,
Liberals, you name it) and everyone have it all wrong?" I think the key
virtue is to avoid reaching a point where one is pushed the point of
frustation and futility, and does nothing. I just keep asking the question.
"truth is many, truth is one"
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>>>>>>
But asking "what if this whole idea is wrong" is also part of the scientific
tradition. The difference is that scientists try to answer these questions
with experiments, or at least with the most objective data they can collect,
rather than with deconstructionist mumbo-jumbo.
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