Abstract

In the last decade, "evidence-based medicine" (EBM) has become all the rage. Just as the Supreme Court instructed the federal judiciary to take a more critical approach to the assessment of expert testimony, proponents of EBM call on health care professionals to apply the best available evidence when making treatment decisions. Instead of relying on what they may remember from medical school or have learned from their personal experiences (or from drug company sales-persons), EBM insists that physicians consult the biomedical literature for the latest clinical research findings. The fact that the medical profession views such an idea as novel—even radical—offers a startling picture of traditional ("opinion-based") medical practice, one quite different from that imagined by courts and regulatory agencies when they blithely assume that physicians can effectively assimilate tremendous quantities of complex information. EBM may, however, embody some naive assumptions about the character of the available scientific evidence, failing to appreciate shortcomings such as the extent to which conflicts of interest have affected the biomedical literature. Nevertheless, the debate surrounding evidence-based medicine offers important insights for various decisionmakers when they address health care quality issues. In turn, legal institutions may help to facilitate EBM by addressing conflicts of interest in biomedical research and by encouraging physicians to rely on rigorous research rather than largely anecdotal information when treating their patients.

How to Cite