Loughlin Michael
Manchester Metropolitan University, Cheshire, UK.
J Eval Clin Pract. 2008 Oct;14(5):665-71. doi: 10.1111/j.1365-2753.2008.01075.x.
Both defenders and certain critics of evidence-based medicine (EBM) share philosophical commitments - assumptions about the meaning of and relationship between such fundamental concepts as 'objectivity', 'subjectivity' and 'rationality'- that frame the debate between them. Critics need to be particularly careful in analysing their own philosophical commitments. Ironically, failure to do so has led some to ground their rejection of EBM in philosophical theses that are less clear and/or more contentious than the reasonable conclusions they wish to defend. There is no need to label 'objectivity' a 'myth' or 'scientific method' an 'illusion' in order to identify what is wrong in EBM. Such strategies play into the hands of EBM dogmatists, allowing them to continue to position themselves as the defenders of 'science' and 'reason'.
循证医学(EBM)的支持者和某些批评者都有哲学上的信奉——关于“客观性”“主观性”和“合理性”等基本概念的意义及相互关系的假设——这些假设构成了他们之间的争论框架。批评者在分析自身的哲学信奉时需要格外谨慎。具有讽刺意味的是,未能做到这一点导致一些人将其对循证医学的拒斥建立在哲学论点之上,而这些论点比他们想要捍卫的合理结论更不清晰和/或更具争议性。为了找出循证医学中的问题,没有必要将“客观性”称为“神话”,或将“科学方法”称为“幻觉”。这些策略正中循证医学教条主义者的下怀,使他们能够继续将自己定位为“科学”和“理性”的捍卫者。