Red Pepper Clinic, 131-133 Birchwood Avenue, Lincoln, LN6 0JE.
University of Bedfordshire, Healthcare Practice, Putteridge Bury Campus, Hitchin Road, Luton, LU2 8LE.
Br Dent J. 2019 Feb 8;226(3):177-179. doi: 10.1038/sj.bdj.2019.145.
It was a watershed moment when Archie Cochrane published his work on Effectiveness and efficiency: random reflections on health services which was considered the start of evidence-based healthcare as we now know it. From there onward, evidence-based dentistry (EBD) has developed and evolved and there has been little attention to the interlink between EBD and ethics. The aim of this paper is to explore some of the ethical basis of evidence-based approach to healthcare utilising Beauchamp and Childress' four principles. EBD will be examined in relation to a variety of ethical theories. The case will be made that dentistry can, at times, be considered the orphaned field of medicine and an examination will be presented about how this may affect the uptake of EBD in practice. While exploring the strengths and weaknesses of EBD from an ethical viewpoint, we will highlight some of the challenges facing many dental practitioners in judging what is considered high-quality evidence and examine ways in which this could be improved with links to patient outcomes from an ethical perspective.
当阿奇· Cochrane 发表他的关于“有效性和效率:对卫生服务的随机思考”的著作时,这是一个具有里程碑意义的时刻,该著作被认为是我们现在所知道的循证医疗保健的开端。从那时起,循证牙科(EBD)已经发展和演变,而很少关注 EBD 和伦理之间的联系。本文旨在利用 Beauchamp 和 Childress 的四项原则探讨循证医疗保健方法的一些伦理基础。将从各种伦理理论的角度来考察 EBD。本文将提出一个观点,即有时牙科可以被认为是医学的孤儿领域,并将对这如何影响 EBD 在实践中的应用进行考察。在从伦理角度探讨 EBD 的优缺点的同时,我们将强调许多牙医在判断什么是高质量证据时所面临的一些挑战,并从伦理角度探讨如何通过与患者结果的联系来改进这一点。