Reconstructing data: evidence-based medicine and evidence-based public health in context.
The emergence of Evidence-Based Medicine (EBM) as the gold-standard practice in biomedicine and public health practices represents a significant epistemological turn in modern medicine. The development of Evidence-Based Public Health (EBPH) followed the emergence of Evidence-Based Medicine, as an attempt to ground health policies and interventions on "sound facts". The present paper analyzes the historical and sociological roots of this turn. We evaluate the ethical and social consequences of this transformation, both within the medical profession (the polarization between a medical elite which strengthened its professional status, and a rank and file which experienced a process of "de-professionalization") and in its relationship to the welfare state (the link between the medical elite, EBM, EBPH and the commodification of health care and public health).
Nadav
Davidovitch
D
Center for the History and Ethics of Public Health, Mailman School of Public Health, Columbia University, USA. nd2166@columbia.edu
Dani
Filc
F
D019317:Evidence-Based Medicine / Q000266:history; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008329:Managed Care Programs; D011634:Public Health / Q000266:history; D013223:Statistics as Topic