Contextualizing science in the aftermath of the evidence-based medicine era: on the need for person-centered healthcare

“By limiting himself to the task of diagnostic categorisation and to the use of pharmacological and other interventions in the investigation, treatment and follow-up of the patient, the modern clinician becomes easily characterised more as a technician in applied bioscience, delivering modalities dictated by algorithmic guidance and commissioner/reimbursement-dictated protocols, rather than by acting as a caring professional with the particular requirements of the unique individual at the forefront of the ‘clinical mind’.”

The issues surrounding so-called “evidence-based” practice are relevant to healthcare generally, and perhaps especially relevant to mental healthcare. The same applies to the key importance of contextualisation.

The article cited above – Contextualizing science in the aftermath of the evidence-based medicine era – was written by Prof. Andrew Miles and published in the European Journal for Person Centered Healthcare. It begins:

“How are we to deal with what Charon [1] has called ‘the vexing failures of medicine, its relentless positivism, its damaging reductionism, its appeal to the sciences and not to the humanities in the Academy and its wholesale refusal to take into account the human dimensions of illness and healing’? Why is it that the ability of doctors to care for their patients as individuals has been lost in what the former Regius Professor of Medicine at Oxford University, David Weatherall [2], refers to as ‘a morass of expensive high technology investigation and treatment’, so that modern medicine has become a ‘failure’ …”

  1. Charon, R. (2006). The self-telling body. Narrative Inquiry 19, 191-200.
  2. Weatherall, D. (1996). Science and the Quiet Art: The Role of Medical Research in Health Care. New York: W.W. Norton.

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