If not evidence, then what? Or does medicine really need a base?

Abstract

This essay analyses the concept of ' base' in relation to its use in evidence-based medicine (EBM). It evaluates the extent to which evidence provides a sufficient base for health care to rest and discusses whether medicine needs a base, and, if so, what are the other possible candidates. This paper will argue that EBM is linked epistemologically to the theory of foundationalism and shows how important criticisms of EBM emerge from anti-foundationalist epistemologies and interpretive frameworks. Drawing from recent writings in the philosophy of science, it is argued that there is a need to see multiple perspectives relevant to the practice and understanding of medicine.