Evidence based or person centered? An ontological debate

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Abstract
Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, since the two seem committed to conflicting ontologies. This paper aims to make explicit some of the most fundamental assumptions that motivate EBM and PCH, respectively, in order to show that the choice between them ultimately comes down to ontological preference. While EBM has a solid foundation in positivism, or what I here call Humeanism, PCH is more consistent with causal dispositionalism. I conclude that if there is a paradigmatic revolution on the way in medicine, it is first of all one of ontology.
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Archival date: 2016-09-02
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Rethinking Bias and Truth in Evidence-Based Health Care.Wieringa, Sietse; Engebretsen, Eivind; Heggen, Kristin & Greenhalgh, Trish
Reasoning, Evidence, and Clinical Decision-Making: The Great Debate Moves Forward.Loughlin, Michael; Bluhm, Robyn; Buetow, Stephen; Borgerson, Kirstin & Fuller, Jonathan

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