Evidence Based Medicine and Ethics

Steve Simon


The Journal of Medical Ethics has a series of articles about ethics and evidence based medicine. These are pre-prints of articles under review and you can prepare a response to these articles. I found the article “Ethical problems arising in evidencebased complementary and alternative medicine” Edzard Ernst, Michael H. Cohen, Julie Stone [pdf] to be especially intriguing. I hope to write a web page sometime about whether the standards of evidence based medicine should be modified for alternative therapies. There is a lot of discussion about how randomized trials are “reductionist” and while some of this is post-modernist nonsense, there are still some points worth considering. On the other side of the equation, since alternative medicine claims often violate many of the criteria for causality, perhaps their claims should be held to an even higher standard (extraordinary claims require extraordinary proof).

Another pre-print, “Ethics and Evidence-based Surgery” Gordon M. Stirrat [pdf], to be interesting. Surgery is an area where good evidence is hard to get, partly because blinding and the use of placebo operations are often problematic. I also liked this article, because the author cited one of my works, “Is the randomized clinical trial the gold standard of research?” [Medline].

It’s not clear if the full text of these papers will remain available after they have been officially published.

You can find an earlier version of this page on my original website.