title: Evidence-based medicine and epistemological imperialism: narrowing the divide between evidence and illness.
abstract: Evidence-based medicine (EBM) has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the evidence we have about disease and its treatment. This creates a significant ethical, epistemological and ontological challenge for medicine.
authors.affiliation: Department of Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Crowther
authors.forename: Wendy
authors.initials: W
authors.lastname: Lipworth
authors.forename: Ian
authors.initials: I
authors.lastname: Kerridge
mesh_terms: D035843:Biomedical Research / Q000941:ethics / Q000458:organization & administration*; D003466:Cultural Characteristics; D020732:Cytogenetic Analysis; D019317:Evidence-Based Medicine / Q000941:ethics / Q000458:organization & administration*; D006801:Humans; D007938:Leukemia / Q000145:classification; D010686:Philosophy, Medical; D016032:Randomized Controlled Trials as Topic; D012107:Research Design