The Philosophy of Evidence-Based Medicine - by Jeremy H Howick (Paperback)

Book Synopsis

Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.

From the Back Cover

The controversy surrounding the significance of evidence-based medicine (EBM) in clinical practice, far from abating, has grown and developed a momentum of its own.

This book examines the arguments for and against EBM being a new paradigm in medicine, and puts together the most coherent and compelling case as to how and why its rigor should be applied to every facet of patient care; discussing the questions often raised by critics of evidence-based medicine:

• Why should EBM dominate health care, from daily medical practice to funding treatments?
• Is it truly objective?
• Do we need randomized trials for treatments that are universally accepted as effective?
• Does EBM serve the needs of individual patients?
• What part do basic sciences play in EBM?
• Are randomized trials more important than clinical experts?

Students of evidence-based medicine, researchers and those studying the philosophy of science or medicine will find this detailed treatise an invaluable reference to the development of EBM, from recognition of the validity of randomized controlled trials to today's more patient-centred approach.

Titles of Related Interest

Clinical Thinking: Evidence, Communication and Decision-Making
Chris Del Mar, Jenny Doust, Paul P. Glasziou
ISBN: 978-0-7279-1741-6

Evidence-based Decisions and Economics: Health care, social welfare, education and criminal justice, 2nd Edition
Ian Shemilt, Miranda Mugford, Luke Vale, Kevin Marsh and Cam Donaldson
ISBN 978-1-4051-9153-1

Review Quotes

"Well-written, concise, engaging. The Evidence-based medicine (from now on 'EBM') movement continues to go from strength to strength, with their hierarchy of medical evidence widely agreed upon and very influential in the theoretical and practical." (The Guardian, 24 January 2014)

Review appeared in The Guardian - 24 January 2014

"In conclusion, The Philosophy of Evidence-Based Medicine is a must-have as a source of knowledge of and reference to the EBM movement. Howick presents the argument for EBM persuasively whilst giving sufficient coverage to alternative positions. I thoroughly recommend this text as both a 'way in' to the subject and a source of deeper understanding in the latest stage of medicine's fascinating journey, full of twists and turns in the search for the truth." (Economics & Philosophy, 1 January 2014)

"The book is well structured and makes an accessible and pleasant read. It deserves to be digested not only by philosophers with a methodological bent but by practitioners of EBM. After two decades of criticisms of various aspects of the increasingly popular EBM way of reasoning, it is about time EBM defenders tried to strike back, clarifying and justifying their positions. Howick's book is a valuable effort that will hopefully enrich the continuing debate." (Theoria, 1 April 2013)

"Jeremy Howick has written the most comprehensive and fair philosophical treatment of EBM to date. Howick understands that EBM is not, first and foremost, a philosophical position, and that its various components (e.g., evidence hierarchies) are not primarily philosophical theses. Rather, they are attempts to improve the efficacy of medicine.... The book approaches its topic with the tools of mainstream analytical philosophy of science." (Philosophy of Science, 2013)

"The Philosophy of Evidence Based Medicine helps answer the question of how to think about medicine so that judgement can be made. The book addresses key questions about medical decision-making, such as: what role should mechanistic reasoning have in determining appropriate medical care? And, what weight, if any, should be given to expert opinions? This isn't a book about how doctors think. It is about how doctors ought to think.... The Philosophy of Evidence Based Medicine is an extremely important and practical book about evidence-based medicine, and I consider it to be one of the most important contemporary books on the subject. I recommend it very highly." (The Medical Media Review, 2012)

"In The Philosophy of Evidence-Based Medicine, Jeremy Howick, PhD offers by far the most fully formed defence to date of the epistemology of EBM.... Well-written and as approachable as any work in the philosophy of science might hope to be.... Howick is to be commended for his careful analysis of epistemic ramifications of many of the methodologies of clinical epidemiology." (Journal of Evaluation in Clinical Practice, 2011)

"Howick's book provides a good overview of EBM's defense of the hierarchy of evidence and an excellent reference list for readers who want to know more about EBM and its critics." (Theory of Medical Bioethics, 2011)

"Since the 1990s, the practice of medicine has become dominated by a new methodological reasoning process - that of evidence-based medicine. This book unpacks the assumptions inherent in this methodology, shedding light on its contributions and limitations to patient care. It addresses misconceptions about and criticisms of EBM in a cogent manner and provides valuable insight into how the current world of medicine is being shaped. (Doody's, 2011)

About the Author

Jeremy Howick PhD
Centre for Evidence-Based Medicine, Department of Primary Care, University of Oxford, UK