Rated as one of the top 15 breakthroughs in medicine over the last 150 years, evidence-based medicine (EBM) has become highly influential in medicine. Put simply, EBM promotes a seemingly irrefutable, principle: that decision-making in medical practice should be based, as much as possible, on the most up-to-date research findings. EBM has been particularly popular within psychiatry, a field that is haunted by a legacy of controversial interventions. For advocates, anchoring psychiatric practice in research data makes psychiatry more scientific valid and ethically legitimate. Few, however, have questioned whether EBM, a concept pioneered by those working in other areas of medicine, can be applied to psychiatric disorders. In this groundbreaking book, the Canadian psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of EBM, and critically examines their applicability to psychiatry. By highlighting the basic ethical tensions between psychiatry and EBM, the author addresses the fundamental and controversial question - should psychiatrists practice evidence-based medicine at all?
Mona Gupta is a psychiatrist and researcher in bioethics at the Universite de Montreal in Montreal, Canada. She received her medical degree from McGill University and then completed her postgraduate training in psychiatry at the University of Toronto where she also received her PhD in bioethics. Dr Gupta has published and presented widely on the subject of ethics and evidence-based medicine in psychiatry.
1. What does evidence have to do with ethics? ; 2. What is evidence-based medicine? ; 3. Ethical values and evidence-based medicine: the debate ; 4. Psychiatry and evidence-based psychiatry ; 5. The critique of evidence-based psychiatry ; 6. The ethics of EBM ; 7. EBM experts talk about ethics, evidence-based medicine, and psychiatry ; 8. Is evidence-based psychiatric practice, ethical practice? ; 9. Conclusions ; Appendix