Evidence-Based Medicine and Women: Do the Principles and Practice of EBM Further Women's Health?
Bioethics 2004 February; 18(1): 50-71
Clinicians and policy makers the world over are embracing evidence-based medicine (EBM). The promise of EBM is to use summaries of research evidence to determine which healthcare interventions are effective and which are not, so that patients may benefit from effective interventions and be protected from useless or harmful ones. EBM provides an ostensibly rational objective means of deciding whether or not an intervention should be provided on the basis of its effectiveness, in theory leading to fair and effective healthcare for all. In this paper I closely examine these claims from the perspective of healthcare for women, using relevant examples. I argue that the current processes of evidence-based medicine contain a number of biases against women. These biases occur in the production of research that informs evidence-based medicine, in the methods used to analyse and synthesise the evidence, and in the application of EBM through the use of guidelines. Finally, the biomedical model of health that underpins most of the medical research used by EBM ignores the social and political context which contributes so much to the ill-health of women.
Evidence-Based Medicine; Guidelines; Health; Medicine; Methods; Medical Research; Patients; Research; Women's Health; Concept of Health; Quality of Health Care; Human Experimentation Policy Guidelines / Institutional Review Boards; Research on Women; Health Care for Minorities; Health Care Programs for Women;
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Doing the Right Thing Right: Is Evidence-Based Medicine the Answer? Review of EVIDENCE-BASED MEDICINE: HOW to PRACTICE and TEACH EBM, by D.L. Sackett, W.S. Richardson, W. Rosenberg and R.B. Haynes; and EVIDENCE-BASED HEALTHCARE: HOW to MAKE HEALTH POLICY and MANAGEMENT DECISIONS, by J.A. Muir Gray) Wallace, Eleanor Z.; Leipzig, Rosanne M. (1997-07-01)
Virtual Guiding Lights Review of the Websites of the National Guideline Clearinghouse (Http://www.guideline.gov); Health Services/Technology Assessment Text (Http://text.nlm.nih.gov/ftrs/gateway/); Ottawa Hospital General Campus Library Evidence-Based Medicine and Practice Resources (Http://www.ogh.on.ca/library/evidence.htm); How to Use a Clinical Practice Guideline (http://hiru.mcmaster.ca/ebm/userguid/8_cpg.htm) Morris, Kelly (1999-04-24)