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Healthy Skepticism Library item: 2104

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Isaacs D, Fitzgerald D.
Seven alternatives to evidence based medicine.
BMJ 1999 Dec 18-25; 319:(7225):1618
http://bmj.bmjjournals.com/cgi/content/full/319/7225/1618


Abstract:

Clinical decisions should, as far as possible, be evidence based. So runs the current clinical dogma. 1 2 We are urged to lump all the relevant randomised controlled trials into one giant meta-analysis and come out with a combined odds ratio for all decisions. Physicians, surgeons, nurses are doing it3-5; soon even the lawyers will be using evidence based practice.6 But what if there is no evidence on which to base a clinical decision?

Keywords:
MeSH Terms: Clinical Competence Decision Making* Evidence-Based Medicine* Humans Wit and Humor

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909