Whither our Art? Clinical Wisdom & Evidence-based Medicine

Parker, M. H. (2002) Whither our Art? Clinical Wisdom & Evidence-based Medicine. Medicine, Health Care and Philosophy, 5 3: 273-280. doi:10.1023/A:1021116516342

Author Parker, M. H.
Title Whither our Art? Clinical Wisdom & Evidence-based Medicine
Journal name Medicine, Health Care and Philosophy   Check publisher's open access policy
ISSN 1386-7423
Publication date 2002-10-01
DOI 10.1023/A:1021116516342
Volume 5
Issue 3
Start page 273
End page 280
Total pages 8
Editor Henk tan Have
Place of publication Dordrecht, Netherlands
Publisher Kluwer Academic Publishers
Language eng
Subject C1
329999 Medical and Health Sciences not elsewhere classified
730199 Clinical health not specific to particular organs, diseases and conditions
Abstract The relationship between evidence-based medicine (EBM) and clinical judgement is the subject of conceptual and practical dispute. For example, EBM and clinical guidelines are seen to increasingly dominate medical decision-making at the expense of other, human elements, and to threaten the art of medicine. Clinical wisdom always remains open to question. We want to know why particular beliefs are held, and the epistemological status of claims based in wisdom or experience. The paper critically appraises a number of claims and distinctions, and attempts to clarify the connections between EBM, clinical experience and judgement, and the objective and evaluative categories of medicine. I conclude that to demystify clinical wisdom is not to devalue it. EBM ought not be conceived as needing to be limited or balanced by clinical wisdom, since if its language is translatable into terms comprehensible and applicable to individuals, it helps constitute clinical wisdom. Failure to appreciate this constitutive relation will help perpetuate medical paternalism and delay the adoption of properly evidence-based practice, which would be both unethical and unwise.
Keyword clinical experience
clinical freedom
clinical judgement
clinical practice guidelines
clinical wisdom
evidence-based medicine
Q-Index Code C1

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Created: Wed, 15 Aug 2007, 03:50:06 EST