The argument against evidence-based practice reminds me of quotes I have
heard credited Max Planck and Thomas Kuhn:

"An important scientific innovation rarely makes its way by gradually
winning over and converting its opponents: it rarely happens that Saul
becomes Paul.  What does happen is that its opponents gradually die out and
that the growing generation is familiarized with the idea from the
beginning."  Max Planck 1936

"Though some scientists, particularly the older and more experienced ones,
may resist indefinitely, most of them can be reached in one way or another.
Conversions will occur a few at a time until, after the last holdouts have
died, the whole profession will again be practicing under a single, but now
different, paradigm." Thomas Kuhn, 1962

Although, the problem with EBP is that new doctors can always find a mentor
who will help them perpetuate the old think and thus lengthen the time it
takes for a complete paradigm shift.  Couple that with the problem of a lack
of belief in knowledge noted by Prof. Cooperman in a great letter to the
editor in Newsweek.  Cooperman was writing in reply to an article on the
denial of global warming.  His comment speaks to a societal problem that I
believe affects health care providers too:

"Sharon Begley's article about "the denial machine," as frightening as it
was, misses a crucial aspect of the problem. It is not just that well-heeled
corporations are buying up politicians or promoting
science-as-they-want-it-to-be. It is that our society is more than happy to
accept spin and cant because we have come to believe that all expertise is
bias, that all knowledge is opinion, that every judgment is relative. I see
this daily in my university classroom. Many of even my best students seem to
have lost the ability to think critically about the world. They do not
believe in the transformative power of knowledge because they do not believe
in knowledge itself. Begley decries the tactic of making the scientists
appear divided, but the corporations didn't have to invent this tactic. It
is built into our carefully balanced political "debates," into our news
shows with equal time given to pundits from each side and into the
"fairness" we try to teach in our schools. We need not be surprised that
people have become consumers who demand the right to choose as they wish
between the two equally questionable sides of every story. Neither global
warming nor any other serious problem can be addressed by a society that
equates willful ignorance with freedom of thought.
Bernard Dov Cooperman
Dept. of History, University of Maryland
COLLEGE PARK, MD"

Steven Colbert calls this the problem with truthiness.

Stephen  


Stephen M. Perle, D.C., M.S.

Associate Editor, Chiropractic and Osteopathy

Professor of Clinical Sciences
Adjunct Professor of Mechanical Engineering
University of Bridgeport, Bridgeport, CT 06604 USA
www.bridgeport.edu/~perle 

Chiropractic and Osteopathy www.chiroandosteo.com 
________________________________________
So no degree of commitment to beliefs makes them knowledge.
Indeed, the hallmark of scientific behavior is a certain
skepticism even towards one's most cherished theories. Blind
commitment to a theory is not an intellectual virtue: it is an
intellectual crime. 
Imre Lakatos - "Science and Pseudoscience"


> -----Original Message-----
> From: Evidence based health (EBH) [mailto:EVIDENCE-BASED-
> [log in to unmask]] On Behalf Of Martin Dawes, Dr.
> Sent: Tuesday, January 06, 2009 10:28 AM
> To: [log in to unmask]
> Subject: Social Epistemology - I wonder if they believe in evolution -
> after all it explains biology and without that we dont even have .......
> 
> If we want some perspective on science and controversy can I bring to the
> table the anniversary of Darwin born 200 years ago, whose seminal book was
> published 150 years ago almost to the day. Intelligent design is rife in
> the United States where 47% of the population do not believe the
> evolutionary theory despite the evidence of many years work. What makes
> this particularly relevant to us is that without the theory of evolution
> we would not either have biology as we now know it or, for example,
> understand the mechanisms of drug metabolism.
> While I am not suggesting complacency about this sort of ill informed
> criticism of EBM I do think it helps to know that we are not alone as
> scientists and that we are in for a very very very long debate.
> Martin
> 
>