Ethics and Evidence-Based Medicine: Is There a Conflict?

Erich H. Loewy, MD

In This Article


I have discussed the advantages and disadvantages of EBM protocols. While it is my view that they may serve as guidelines, the danger of their becoming straightjackets is by no means trivial. Such a procedure threatens to separate the patient's uniqueness further from the physician and would support looking at the disease instead of at the patient who happens to have that disease. In making all treatment a routine, it may well decrease physicians' curiosity and cause them to overlook important incidental findings. Beyond this, the danger of using EBM protocols not mainly to help patients (and perhaps jog the physician's memory) but as a cost-saving device is deplorable. There is no doubt that costs must be held down and waste eliminated. Until that is done, starting to talk about rationing is not the problem -- rationalization is.


I specifically want to thank Dr. Eike-Henner Kluge of the University of Victoria and Dr. Chris Hackler of the University of Arkansas for their valuable suggestions.


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