What Counts as 'What Works': Expertise, Mechanisms and Values in Evidence-Based Medicine

Abstract

My doctoral project is a study of epistemological and ethical issues in Evidence-Based Medicine (EBM), a movement in medicine which emphasizes the use of randomized controlled trials. Much of the research on EBM suggests that, for a large part of the movement's history, EBM considered expertise, mechanisms, and values to be forces contrary to its goals and has sought to remove them, both from medical research and from the clinical encounter. I argue, however, that expertise, mechanisms and values have important epistemological and ethical roles to play and can be incorporated into the current EBM movement.