“Evidence-Based Medicine”

While studying for school, I came across these two lectures: here and here. These lectures talk about “evidence-based medicine” which it defines as identical to medicine “shown” effective via randomly controlled trials.

One possible view Critical Rationalists could take with the term “Evidence-Based Medicine” is to object to such language on the grounds that it is counter to Popper’s theory since evidence can’t prove anything nor can it suggest a theory but can only help pick between already existing theories by refuting some of them.

It seems to me that in the context of this example, these objections don’t make sense. Medicine is never trying to “prove” things in any absolute sense. Its context is always uncertain. And medical science is not making the mistake of trying to suggest that observations can exist absent of theories. We all know that contextually “evidence-based medicine” means that they use a randomized controlled trial to create problems for the next two best competing theories: the placebo effect and the body naturally getting better on its own.

I believe this is a solid example of why the language of “evidence-based” and “shown” or “proven” aren’t necessarily at odds with Popper’s theories and are often contextually sound. I know some Critical Rationalists accept “proven” in particular as meaning simply “according to our best theories” and I approve of this use of the term. Brett Hall has a great article on this.

To try to force-fit “evidence-based medicine” into the language of refutation would require unnecessary contortions of language. I much more easily understand the phrase “proven evidence-based medicine” than “medicine that had a randomized controlled trial to create problems for the placebo and natural healing alternative theories.”

Image by Free-Photos from Pixabay

An Update:

After I wrote this post, but before it was published, Bart asked me a question about “evidence-based medicine” wondering how David Deutsch would look at it. After a discussion with him, I want to offer an insight that came out of the discussion that differs a bit from what I said above.

As I argued above, ‘evidence-based medicine’ is a term that corresponds to the Popperian concept of observations making the alternative theories (placebo and natural healing) problematic. So I argued that it is not inconsistent with Popperian epistemology. However, Bart points out that it’s not clearly an explanation either.

I think it is an explanation, but only a very high-level one. See my discussion on Causal Inference for details on how it is an explanation. An explanation can be as simple as “this medicine causes this outcome.”

However, I have to admit I see Bart’s point. This, by itself, isn’t a great explanation and it could (and should) be improved. In Medicine’s defense, if you do read through the literature that comes with prescriptions, they are often full of explanations on how they theorize that the medicine really works. But perhaps one of the shortcomings of modern medicine today is that, at times, we’ve let our faith in statistical theory trump our desire to seek improving explanations. Even today we have no idea how Aspirin works. Is there a “Popperian” approach here that would improve on the current approach?

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