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Professionalism, Indeterminacy and the EBM Project

Published online by Cambridge University Press:  01 March 2007

David Armstrong
David Armstrong
Affiliation:
Department of General Practice, King’s College London, 5 Lambeth Walk, London SE11 6SP, UK E-mail: david.armstrong@kcl.ac.uk
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Abstract

Who controls indeterminacy in the doctor–patient encounter defines the nature of professional power. Evidence-based medicine (EBM) is one such control strategy claiming to reduce uncertainty by identifying effective (and efficient) interventions and by removing ineffective treatments from clinical practice. EBM, however, as a means of keeping some autonomy for a profession beset by increasing government control, has had to compete with other professionalizing strategies within medicine. And, despite its promise, EBM is shown not to have reduced indeterminacy but to have shifted the problem into a wider policy arena that involves interpreting evidence. Moreover, in an era of concern for patient safety, EBM is proposed as part of a solution (through its claim to reduce uncertainty about the effect of interventions) but remains itself a potent source of danger and increased indeterminacy.

Keywords

EBMindeterminacyprofessions
Type
Articles
Information
BioSocieties , Volume 2 , Issue 1: Special Issue: The Construction and Governance of Randomised Controlled Trials , March 2007 , pp. 73 - 84
Copyright
Copyright © London School of Economics and Political Science 2007

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