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Evidence-based Medicine: Defining Evidence

The overall goals of evidence-based medicine (EBM) are to provide physicians and medical
personnel with the best information available in the field so that the clinical practices of these
professionals provide patients with the best possible care. 



The Philosophy of Evidence-based Medicine

Science and Medicine: Objectivity vs. Subjectivity

Medical Rhetoric as a Social and Communicational Construct

The Social and Rhetorical Implications of Medical Discourse

The Social and Rhetorical Implications of Defining Evidence



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The Social and Rhetorical Implications of Medical Discourse

The persuasive aspects of the Sackett et al. text may not seem significant to an audience that is interested in reading the material solely for the purpose of learning the step by step techniques of practicing EBM, but the rhetorical and social implications of medicine can have a profound effect on the behavior of people, going so far as to completely contradict what raw statistics show to be the logical behavior.  An excellent example of this seemingly reversed effect is found in the issues surrounding breastfeeding infants.  While numerous studies show that breastfeeding is highly preferable to formula/bottle-feeding and numerous professional medical organizations endorse breastfeeding, only twenty percent of US infants are breastfed through six months of age (Hausman 271).  This number shows a significant gap between the logical medical conclusion that most mothers should breastfeed their infants and the reality that most mothers do not.  Bernice Hausman explores the rhetorical and social aspects of this phenomenon and concludes that the primary factors responsible for this discrepancy are social stigmas about motherhood in general and breastfeeding in particular and the inability of the medical rhetoric to effectively persuade mothers to practice breastfeeding in spite of these social stigmas.  Hausman’s conclusions on the ineffectiveness of the current medical rhetoric surrounding this issue show that medical professionals have not entered the level of social discourse that addresses the issues concerning these women and therefore have been unsuccessful in convincing them to follow what is fairly obviously a healthy medical practice (273–287).  This ability—or inability—of medical practitioners to effectively communicate is central to the goals of EBM since without this communication, the “current best evidence” that the EBM text so repeatedly stresses will never be shared, available, and/or practiced in a usable format.


Written by Amanda Fullan, University of Wisconsin, Eau Claire
Last Updated December 15, 2001