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The philosophy of medicine is a branch of philosophy that includes the epistemology, ontology/metaphysics, and ethics of medicine. Perhaps the most well known area is medical ethics, which overlaps with bioethics. It can be distinguished from the philosophy of healthcare, which is mostly concerned with ethical and political issues arising from healthcare research and practice. There are a variety of university courses, journals, books and conferences dedicated to the philosophy of medicine. There is also a new direction, or school, in the philosophy of medicine termed analytic philosophy of medicine.
Epistemology is the study of knowledge. The ways in which health-care professionals (ranging from clinicians to biomedical scientists) come to know and use knowledge, whether as individuals or as groups, are central concerns of medical epistemology. Many different claims to knowledge have been identified.
Evidence-based medicine (EBM) is underpinned by the study of the ways in which we can gain knowledge regarding key clinical questions such as the effects of medical interventions, the accuracy of diagnostic tests, and the predictive value of prognostic markers. EBM provides an account of how medical knowledge can be applied to clinical care. EBM not only provides clinicians with a strategy for best practice, but also, underlying that, a philosophy of evidence.
Interest in the EBM philosophy of evidence has led philosophers to consider the nature of EBM’s hierarchy of evidence, which rank different kinds of research methodology, ostensibly, by the relative evidential weight they provide. Key questions asked about hierarchies of evidence concern the legitimacy of ranking methodologies in terms of the strength of support that they supply; how instances of particular methods may move up and down a hierarchy; as well as how different types of evidence, from different levels in the hierarchies, should be combined.
Additionally the epistemological virtues of particular aspects of clinical trial methodology have been examined, mostly notably the special place that is given to randomisation, the notion of a blind experiment and the use of a placebo control.
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