At 01.29 08/08/2009 +0100, Michael Power wrote:
>I suspect that the author's chose their narrow definition (thus creating a
>false dichotomy) so that they could make their article more dramatic, for
>example by using the image of medical humanism colliding with EBP. In fact
>EBP coalesced with medical humanism at least 9 years ago. If EBP is
>imperfectly practiced, this is evidence of a problem with the practice,
>not with EBP.
What you say is quite right, but after following the thread, I am coming to
he conclusion that if the problem reported by Groopman and Hartzband
(improper "mandatory" use of guidelines promoted by administrative
measures) is real, the political conflict is not be between EBM and shared
decision making (or whatever), but within EBM itself (simplifying: between
EBP and "deviated" totalitarian EBHC), and others probably will take
advantage of it.
Shouldn't be the problem to ensure that guidelines properly provide honest
information on all the available options (not just the ones for which there
is more evidence from sponsored trials), clear directions for patient
involvement, and freedom of choices for different patient preferences,
values and goals?
regards,
Piersante Sestini
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