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非传统疗法与循证医学:对意大利相关法规的科学与伦理分析

Non-conventional practice versus evidence-based medicine. A scientific and ethical analysis of the Italian regulation.

作者信息

Patuzzo Sara, Ciliberti Rosagemma

机构信息

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出版信息

Acta Biomed. 2017 Aug 23;88(2):143-150. doi: 10.23750/abm.v88i2.5863.

Abstract

BACKGROUND

The current lack of scientific validation of non-conventional treatments in medicine, whose epistemological foundations lie in scientific evidence and experimentation, raises significant questions regarding the costs and benefits of alternative-treatment forms. Nonetheless, in the last few decades non-conventional treatments have been increasingly recognised by the Italian medical profession, with one regional healthcare administration adopting some non-conventional practices as part of its conventional healthcare services.

AIMS

The Authors aim to analyse non-conventional treatments in medicine from an epistemological, cultural, ethical, political and economic point of view, in order to highlight criticalities and incongruities, especially when these treatments are approved by a public healthcare system, which should be grounded on the "evidence-based medicine" principle.

CONCLUSIONS

Non-conventional treatments in medicine are constituted by meta-theories, i.e. philosophical, religious and ideological concepts that conflict with contemporary rational, empirical medicine. In the interest of patients and society, the paper stresses the incongruity of a healthcare system which, despite being grounded on the "evidence-based medicine" principle, allows the development of non conventional treatments. Having said that, medical science should address not only the biological domain of illness but also its existential implications. Awareness and respect for the individual experience can undoubtedly lead to a new medical model that allows for a more effective therapeutic intervention.

摘要

背景

医学中非传统治疗方法目前缺乏科学验证,其认识论基础在于科学证据和实验,这引发了关于替代治疗形式的成本和效益的重大问题。尽管如此,在过去几十年里,非传统治疗方法越来越受到意大利医学界的认可,一个地区的医疗保健管理部门已采用一些非传统做法作为其传统医疗服务的一部分。

目的

作者旨在从认识论、文化、伦理、政治和经济角度分析医学中的非传统治疗方法,以突出其中的关键问题和不一致之处,特别是当这些治疗方法得到公共医疗系统认可时,而公共医疗系统应以“循证医学”原则为基础。

结论

医学中的非传统治疗方法由元理论构成,即与当代理性、实证医学相冲突的哲学、宗教和意识形态概念。为了患者和社会的利益,本文强调了一个基于“循证医学”原则却允许非传统治疗方法发展的医疗系统的不一致性。话虽如此,医学科学不仅应关注疾病的生物学领域,还应关注其存在意义。对个体经验的认识和尊重无疑可以带来一种新的医学模式,从而实现更有效的治疗干预。

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