A philosophical argument against evidence-based policy

This article by Rani Anjum and Stephen Mumford was published (May 2016) in the Journal of Evaluation in Clinical Practice. Its subject – evidence-based policy and practice – is as relevant to mental healthcare as it is to biophysical healthcare.

The article begins:

The two components of evidence-based medicine

Should one always recommend the intervention that has been shown to be best in medical trials? Evidence-based medicine (EBM) tells us so, but we think this is a more complicated matter than at first it seems. To show this, we will distinguish two logically separate components of EBM. One is ontological, and the other concerns policy and decision making.

The ontological component is the assertion that there is a best way to discover and establish causal effectiveness. We call this component ontological because ontology in philosophy concerns the nature of reality – what there is in the world – and this is the part of EBM that professes to deliver such knowledge. The knowledge EBM gives us concerns what causes what: the causes of disease and recovery, for example …”

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