Rethinking bias and truth in evidence-based health care
| Autor: | Trisha Greenhalgh, Kristin Heggen, Sietse Wieringa, Eivind Engebretsen |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Biomedical Research
Modern philosophy Special issue: 2018 Philosophy Thematic Issue Ideal (ethics) Practical reason 03 medical and health sciences 0302 clinical medicine Bias Humans 030212 general & internal medicine Limit (mathematics) Sociology Philosophy Medical Ethical Relativism science Relativism evidence‐based medicine Science Context and Value: Expanding Conceptions Rethinking Categories practical reasoning 030503 health policy & services Health Policy epistemology Public Health Environmental and Occupational Health Cornerstone Evidence-based medicine 16. Peace & justice 3. Good health Epistemology Knowledge Absolute (philosophy) Evidence-Based Practice Original Article 0305 other medical science |
| Zdroj: | Journal of Evaluation in Clinical Practice |
| ISSN: | 1356-1294 |
| Popis: | In modern philosophy, the concept of truth has been problematized from different angles, yet in evidence‐based health care (EBHC), it continues to operate hidden and almost undisputed through the linked concept of “bias.” To prevent unwarranted relativism and make better inferences in clinical practice, clinicians may benefit from a closer analysis of existing assumptions about truth, validity, and reality. In this paper, we give a brief overview of several important theories of truth, notably the ideal limit theorem (which assumes an ultimate and absolute truth towards which scientific inquiry progresses), the dominant way truth is conceptualized in the discourse and practice of EBHC. We draw on Belgian philosopher Isabelle Stengers' work to demonstrate that bias means one thing if one assumes a world of hard facts “out there,” waiting to be collected. It means something different if one takes a critical view of the knowledge‐power complex in research trials. Bias appears to have both an unproductive aspect and a productive aspect as argued by Stengers and others: Facts are not absolute but result from an interest, or interesse: a bias towards a certain line of questioning that cannot be eliminated. The duality that Stengers' view invokes draws attention to and challenges the assumptions underlying the ideal limit theory of truth in several ways. Most importantly, it casts doubt on the ideal limit theory as it applies to the single case scenario of the clinical encounter, the cornerstone of EBHC. To the extent that the goal of EBHC is to support inferencing in the clinical encounter, then the ideal limit as the sole concept of truth appears to be conceptually insufficient. We contend that EBHC could usefully incorporate a more pluralist understanding of truth and bias and provide an example how this would work out in a clinical scenario. |
| Databáze: | OpenAIRE |
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