title: [Does evidence-based surgery harm autonomy in clinical decision making?].
abstract: Evidence-based clinical guidelines in surgery are frequently confronted with scepticism by the medical staff, especially because a confinement of free decision making in therapy is expected. Considering that medicine is not merely natural science, but can as well be comprehended as social science or art, evidence-based medicine (EbM) may lead to an oversimplified and rigid standardization in medical care ("cook book medicine"). In addition, scientific progress might be prevented by inflexible guidelines. However, it is important for surgeons to engage in the development of evidence-based guidelines in order to put forward their interests, because it is the lack of medical guidelines that might threaten free decision making in surgery - by not confronting economical pressure with decisive minimal standards in medical care. Therapeutical freedom is a substantial principle in medicine, but it should be considered that according to occidental tradition, "freedom" is necessarily involving reason and conscientiousness.
authors.affiliation: Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth.
authors.forename: J
authors.initials: J
authors.lastname: Loss
authors.forename: E
authors.initials: E
authors.lastname: Nagel
mesh_terms: D002983:Clinical Competence / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards; D003363:Cost Control / Q000639:trends; D019317:Evidence-Based Medicine / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards*; D005544:Forecasting; D005858:Germany; D006801:Humans; D020407:Internet / Q000639:trends; D019300:Medical Errors / Q000191:economics / Q000331:legislation & jurisprudence / Q000517:prevention & control; D026684:Personal Autonomy; D010819:Physician's Role; D017410:Practice Guidelines as Topic / Q000592:standards*; D017009:Professional Autonomy; D013514:Surgical Procedures, Operative / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards*; D016896:Treatment Outcome