Is There a Tension Between Doctors' Duty of Care and Evidence-Based Medicine?
- Wendy A. Rogers
- … show all 1 hide
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
The interaction between evidence-based medicineand doctors' duty of care to patients iscomplex. One the one hand, there is surely anobligation to take account of the bestavailable evidence when offering health care topatients. On the other hand, it is equallyimportant to be aware of important shortcomingsin the processes and practices ofevidence-based medicine. There are tensionsbetween the population focus of evidence-basedmedicine and the duties that doctors have toindividual patients. Implementingevidence-based medicine may have unpredictableconsequences upon the overall quality of healthcare. Patients may have a range of reasons forpreferring one form of treatment over another,not all of which are captured by currentformulations of evidence. This paper examinesthese issues, using relevant examples fromevidence-based medicine.
- Acheson, D. (1998) Independent Inquiry into Inequalities in Health. London: Stationery Office.
- Ashcroft, R., Hope, T. and Parker, M. (2001) Ethical Issues and Evidence-Based Patient Choice. In A. Edwards and G. Elwyn (Eds.), Evidence-Based Patient Choice: Inevitable or Impossible? (pp. 53–65). Oxford: Oxford University Press.
- Beauchamp, D. (1999) Community: The Neglected Tradition of Public Health. In D. Beauchamp and B. Steinbock (Eds.), New Ethics for the Public's Health (pp. 57–67). New York: Oxford University Press.
- Campbell, S., Roland, M. and Buetow, S. (2000) Defining Quality of Care. Social Science and Medicine 51, 1611–1625.
- Cochrane Collaboration (2001) Cochrane Brochure. Cochrane collaboration website: www.cochrane.org/cochrane/cc-broch.htm
- Cookson, R., McDaid, D. and Maynard, A. (2001) Wrong SIGN, NICE Mess: Is National Guidance Distorting Allocation of Resources? British Medical Journal 323, 743–745.
- Dans, A., Dans, L., Guyatt, G.H. and Richardson, S. (1998) Users' Guide to the Medical Literature: XIV. How to Decide on the Applicability of Clinical Trial Results to Your Patient. Journal of the American Medical Association 279, 545–549.
- Dickenson, D. and Vineis, P. (2002) Evidence-Based Medicine and Quality of Care. Health Care Analysis 10, 243–259.
- Entwistle, V.A., Sheldon, T.A., Sowden, A. and Watt, I.S. (1998) Evidence-Informed Patient Choice. International Journal of Technology Assessment in Health Care 14, 212–225.
- Feder, G., Eccles, M., Grol, R., Griffiths, C. and Grimshaw, J. (1999) Using Clinical Guidelines. British Medical Journal 318, 728–730.
- Frijling, B.B., Spies, T.H., Lobo, C.M., Hulscher, M.E., van Drenth, B.B., Braspenning, J.C., Prins, A., van der Wouden, J.C. and Grol, R. (2001) Blood Pressure Control in Treated Hypertensive Patients: Clinical Performance of General Practitioners. British Journal of General Practice 51, 9–14.
- Frith, L. (1999) Evidence-Based Medicine and General Practice. In C. Dowrick and L. Frith (Eds.), General Practice and Ethics: Uncertainty and Responsibility (pp. 29–44). London: Routledge.
- General Medical Council (2001) Duties of a Doctor. GMC website: http://www.gmc-uk.org/ standards/standards_frameset.htm.
- Guyatt, G.H., Sinclair, J., Cook, D.J. and Glasziou, P. (1999) Users' Guides to the Medical Literature: XVI. How to Use a Treatment Recommendation. Journal of the American Medical Association 281, 1836–1843.
- Hope, T. (1996) Evidence-Based Patient Choice. London: King's Fund.
- Horner, J.S. (2000) For Debate: The Virtuous Public Health Physician. Journal of Public Health Medicine 22, 48–53.
- Jones, K. (1996) Trust as an Affective Attitude. Ethics 107, 4–25.
- Lister-Sharp, D., McDonagh, M., Khan, K. and Kleijen, J. (2000) A Systematic Review of the Effectiveness and Cost-Effectiveness of the Taxanes Used in the Treatment of Advanced Breast Cancer and Ovarian Cancer. University of York, York, UK: NHS Centre for Reviews and Dissemination.
- Little, P., Williamson, I., Warner, G., Gould, C., Gantley, M. and Kinmouth, A. (1997) Open Randomised Trial of Prescribing Strategies in Managing Sore Throat. British Medical Journal 314, 722–727.
- Mann, J.M. (1997) Medicine and Public Health, Ethics and Human Rights. Hastings Center Report 27, 6–13.
- McConnachie, A., Watt, G. and Upton, M. (2001) Clinical Guidelines for Coronary Heart Disease Prevention–a Cause of Increasing Health Inequalities? Association of Univer-sity Departments of General Practice 30th Annual Scientific Meeting Programme and Abstracts (p. 17). Parkinson Court, University of Leeds 11-13 July 2002.
- Mooney, G. (1998) “Communitarian Claims” as an Ethical Basis for Allocating Health Care Resources. Social Science and Medicine 47, 1171–1180.
- National Institute for Clinical Excellence (2000) Guidance on the Use of Taxanes for Breast Cancer (Technology Appraisal Guidance). London: National Institute for Clinical Excellence.
- Oswald, N. and Bateman, H. (1999) Applying Research Evidence to Individuals in Primary Care: A Study Using Non-Rheumatic Atrial Fibrillation. Family Practice 16, 414–419.
- Rodriguez-Garcia, R. and Akhter, M. (2000) Human Rights: The Foundation of Public Health Practice. American Journal of Public Health 90, 693–694.
- Rogers, W.A. (2002a) Evidence-Based Medicine in Practice: Limiting or Facilitating Patient Choice? Health Expectations 5, 95–103.
- Rogers, W.A. (2002b) Are Guidelines Ethical? Some Considerations for General Practice. British Journal of General Practice 52, 663–669.
- Rosser, W.W. (1999) Application of Evidence from Randomised Controlled Trials to General Practice. Lancet 353, 661–664.
- Sackett, D.L. (1996) Evidence Based Medicine: What It Is and What It Isn't. British Medical Journal 312, 71–72.
- Scottish Intercollegiate Guidelines Network (1999a) Lipids and the Primary Prevention of Heart Disease: A National Clinical Guideline.
- Scottish Intercollegiate Guidelines Network (1999b) Management of Sore Throat and Indica-tions for Tonsillectomy. Edinburgh, Scotland: Scottish Intercollegiate Guidelines Network.
- van Weel, C. (1996) Chronic Diseases in General Practice: The Longitudinal Dimensions. European Journal of General Practice 2, 17–21
- Is There a Tension Between Doctors' Duty of Care and Evidence-Based Medicine?
Health Care Analysis
Volume 10, Issue 3 , pp 277-287
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers
- Additional Links
- duty of care
- evidence-based medicine
- patient preferences
- Wendy A. Rogers (1)
- Author Affiliations
- 1. Department of General Practice, Flinders University, Australia