Dear Mary,
Your remarks were so cogent I hope you will speak whenever you feel
inclined.
Even taking a very narrow view of the interests of this list (which I am
not inclined to do), it is absurd to think that current events in the US
and Afghanistan will not affect health care and allocation of resources.
This is a very dangerous time for us all.
Regards,
Sue Kaiser
---------------------------------------------------------------------------
Susan Kaiser, MD, PhD, FACS Department Phone: 212-241-3738
Department of Surgery, Box 1259 Practice Phone: 212-241-3336
The Mount Sinai School of Medicine Fax: 212-534-2654
One Gustave L. Levy Place Email: [log in to unmask]
New York, NY 10029-6574
---------------------------------------------------------------------------
On Thu, 1 Nov 2001, [log in to unmask] wrote:
> At 12:05 PM 11/1/01 +0000, you wrote:
> >Hello,
> > Democracy is undoubtably relevant to ebm but surely
> >certain versions of ebm can operate without democracy? I think it needs to be
> >debated what it is about democracy that enables better science, and how
> >our own
> >democracies act as barriers/facilitators of good research and practice.
>
> Perhaps the issue is not altogether democracy but ethics,
> specifically the values, beliefs and practices that guide how we behave
> towards one another. Epidemiology, or EBP if you prefer, is a tool that we
> apply to assist us to make decisions about the allocation of resources
> (money, practitioners' time etc.) Depending on the group's values, this
> tool can be used to help us get the best care for the most people (e.g. if
> our best evidence demonstrates that labour-intensive screening practices
> don't really lead to extra years of life for patients, we can recommend
> that the resources be moved to practices that have a larger pay off). On
> the other hand, we also know that there is potential for this tool to give
> decision-makers ammunition to limit access to valuable care, particularly
> in situations where there is little evidence of benefit simply because no
> controlled studies have been carried out or the care itself is so complex
> and/or future oriented that our tools and research resources aren't always
> up to the task of assessing this care.
> Democracy is yet another tool that helps us make good decisions
> about what we should offer one another. Democracy makes it infinitely
> easier to debate the merits of different ways of allocating resources, but
> it does not ensure ethical decisions.
> So why am I taking up your valuable time to sputter this
> out? Personally, I feel it is important to remember that we use our tool
> of EBP in a societal context that, as humans, we have a duty to
> understand. Because EBP can be used for or against our fellow beings. And
> I think we are at a special time in history when people all over the world
> could say, we will not fight over tools (such as EBP, different political
> systems and cultures and religions), but we will unite to ensure that we
> treat each other as human beings. And this might mean, for us, in the US,
> UK, Canada etc. speaking out against a campaign of displacing and killing
> Afghan people.
> Feeling compelled to post this but promising I will not speak on
> this issue again - Mary
>
>
> Mary Egan, PhD, OT(C)
> Ontario Ministry of Health and Long-Term Care Career Scientist
> School of Rehabilitation Sciences
> School of Nursing
> Faculty of Health Science
> University of Ottawa
> 451 Smyth Road
> Ottawa, Ontario K1H 8M5
> (613) 562-5800 ext 8043
> (613) 562-5428 (fax)
> [log in to unmask]
> http://www.health.uottawa.ca/megan/
>
|