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Journal of Public Health

, Volume 16, Issue 3, pp 169–172 | Cite as

Evidence-based public health: a critical perspective

  • Seiji Yamada
  • Brian Taylor Slingsby
  • Megan K. Inada
  • David Derauf
Comment

Abstract

Background

Evidence-Based Medicine. Physicians who properly practise EBM use both individual clinical expertise and the best available external evidence—neither one to the exclusion of the other. This remains the modality of EBM however and, unfortunately, is rarely practised. Evidence-Based Public Health. Similar to EBM, EBPH too is often misunderstood to mean a direct application of the evidence. Such a dogmatic interpretation of this evidence can be seen as a manifestation of representationalism, the philosophic stance that some ways of looking at the world give a more privileged and unmediated view of reality than others.

Methods and results

This commentary provides a critical perspective on the current use and misuse of EBPH. As EBM has been in usage longer than EBPH, we start with comments on EBM.

Conclusion

A reconsideration of EBPH would admit that values cannot be expunged from our work; rather, they need to play a foundational role. We must draw upon other forms of knowing, such as the arts, in order to practice medicine and public health with attention to transcendent concerns such as morality and social justice.

Keywords

Philosophy, Medical Public health practice Social medicine 

Notes

Conflict of interest statement

The authors declare no relevant associations that might pose a conflict of interest.

References

  1. DeVries RG (2004) The warp of evidence-based medicine: lessons from Dutch maternity care. Soc Sci Med 34(4):595–623Google Scholar
  2. Ellul J (1964) The technological society. Alfred A. Knopf, New YorkGoogle Scholar
  3. Ellul J (1990) The technological bluff. W. B. Saunders, Grand Rapids, MIGoogle Scholar
  4. Good B (1994) Medicine, rationality, and experience. Cambridge University Press, New YorkGoogle Scholar
  5. Guyatt G, Cook D, Haynes B (2004) Evidence based medicine has come a long way. BMJ 329:990–991PubMedCrossRefGoogle Scholar
  6. Kemm J (2005) The limitations of ‘evidence-based’ public health. J Eval in Clin Pract 12(3):319–324CrossRefGoogle Scholar
  7. Rorty R (1982) Consequences of pragmatism. University of Minnesota Press, Minneapolis, MNGoogle Scholar
  8. Rorty R (1991) Objectivity, relativism, and truth. Cambridge University Press, CambridgeGoogle Scholar
  9. Sackett DL, Rosenberg WM, Gray JA et al (1996) Evidence based medicine: what it is and what it isn’t. BMJ 312(7023):71–72PubMedGoogle Scholar
  10. Sontag S (2003) Regarding the pain of others. Farrar, Straus & Giroux, New YorkGoogle Scholar
  11. Straus SE, McAlister FA (2000) Evidence-based medicine: a commentary on common criticisms. CMAJ 163(7):837–841PubMedGoogle Scholar
  12. Tonelli MR (1998) The philosophical limits of evidence-based medicine. Acad Med 73:1234–1240PubMedCrossRefGoogle Scholar
  13. Waitzkin H, Iriart C, Estrada A, Lamadrid S (2001) Social medicine then and now: lessons from Latin America. Am J Pub Health 91(10):1592–1601PubMedCrossRefGoogle Scholar
  14. Wittgenstein L (1953) Philosophical investigations. Blackwell Publishers Ltd, Malden, MAGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Seiji Yamada
    • 1
  • Brian Taylor Slingsby
    • 2
    • 3
    • 4
  • Megan K. Inada
    • 5
  • David Derauf
    • 5
  1. 1.Hawaii/Pacific Basin Area Health Education Center and Office of Medical EducationUniversity of Hawaii John A. Burns School of MedicineHonoluluUSA
  2. 2.George Washington University School of Medicine and Health SciencesWashingtonUSA
  3. 3.The University of Tokyo Graduate School of MedicineBunkyo-kuJapan
  4. 4.Kyoto University Graduate School of Medicine, Konoe-cho YoshidaSakyo-kuJapan
  5. 5.Kokua Kalihi Valley Comprehensive Family ServicesHonoluluUSA

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