Raspe Heiner
Institut für Sozialmedizin, Universitätsklinikum Lübeck.
Z Arztl Fortbild Qualitatssich. 2003 Dec;97(10):689-94.
In Germany evidence-based medicine has gained momentum not before the mid-1990ies. In particular, it started its career in the form of evidence-based health care. Within a few years (1999) the term even became part of Germany's social law. In contrast, clinicians and representatives of medical organisations are still sceptical and reluctant to adopt its concept, methods, and techniques. In part, their critical attitudes have been focusing on the perceived "deprofessionalisation" of the medical profession. Based on sociological and historical arguments and in view of the recently published "Charter on Medical Professionalism", the present paper reports and analyses this criticism. EbM, as an instrument of intraprofessional regulation, will most probably contribute to strengthening the autonomy of the medical profession; this, however, does not preclude the possibility that EbM may restrict the professional autonomy of individual physicians.
在德国，循证医学直到20世纪90年代中期才开始兴起。特别是，它以循证医疗保健的形式开启了其发展历程。在短短几年内（1999年），这个术语甚至成为了德国社会法的一部分。相比之下，临床医生和医学组织的代表仍然持怀疑态度，不愿采用其概念、方法和技术。部分原因在于，他们的批评态度一直集中在医学职业所感受到的“去专业化”上。基于社会学和历史论据，并鉴于最近发表的《医学职业宪章》，本文报告并分析了这种批评。循证医学作为一种专业内部监管手段，很可能有助于加强医学职业的自主性；然而，这并不排除循证医学可能会限制个别医生的职业自主性。
