Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid hierarchy of evidence as the culprit of (...) its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. -/- . (shrink)

This classic remains one of Karl Popper's most wide-ranging and popular works, notable not only for its acute insight into the way scientific knowledge grows, but also for applying those insights to politics and to history.

Described by the philosopher A.J. Ayer as a work of 'great originality and power', this book revolutionized contemporary thinking on science and knowledge. Ideas such as the now legendary doctrine of 'falsificationism' electrified the scientific community, influencing even working scientists, as well as post-war philosophy. This astonishing work ranks alongside The Open Society and Its Enemies as one of Popper's most enduring books and contains insights and arguments that demand to be read to this day.

Thomas S. Kuhn's classic book is now available with a new index.

While evidence-based medicine (EBM) is often accused on relying on a paradigm of 'absolute truth', it is in fact highly consistent with Karl Popper's criterion of demarcation through falsification. Even more relevant, the first three steps of the EBM process are closely patterned on Popper's evolutionary approach of objective knowledge: (1) recognition of a problem; (2) generation of solutions; and (3) selection of the best solution. This places the step 1 of the EBM process (building an answerable question) in a (...) pivotal position for the understanding of the whole process, and underscores a few aspects which are often overlooked in EBM courses. First in this step internal evidence (including personal expertise) must be appraised and integrated in the problem. Second, issues of applicability of the possible solution should be anticipated. Third, and possibly more important, the goal of the intervention should be set at this stage (typically by choosing the outcome in a PICO question). Depending whether or not goals depend on the goals of others, and whether they concern others' voluntary behaviour, goals may be classified as self-serving, moral, altruistic or moralistic. Thus, delicate ethical questions must be addressed at this stage, which means that patient preferences and values must be carefully sought, so that empathy, counselling and narrative medicine must be mastered to be able to formulate correctly an answerable question. The need to modify the current description of the EBM process to increase the recognition of implicit assumptions and increase the consistency of this model is discussed. (shrink)

Unpopular in its day, David Hume's sprawling, three-volume A Treatise of Human Nature (1739-40) has withstood the test of time and had enormous impact on subsequent philosophical thought. Hume's comprehensive effort to form an observationally grounded study of human nature employs John Locke's empiric principles to construct a theory of knowledge from which to evaluate metaphysical ideas. A key to modern studies of eighteenth-century Western philosophy, the Treatise considers numerous classic philosophical issues, including causation, existence, freedom and necessity, and morality. (...) Unabridged republication of the edition originally published by Oxford at the Clarendon Press, London, 1888. Index. Appendix. (shrink)

The essays in this volume represent an approach to human knowledge that has had a profound influence on many recent thinkers. Popper breaks with a traditional commonsense theory of knowledge that can be traced back to Aristotle. A realist and fallibilist, he argues closely and in simple language that scientific knowledge, once stated in human language, is no longer part of ourselves but a separate entity that grows through critical selection.