Historical Backgrounds and Bioethical Implications of Evidence-Based Medicine

Abstract

Introduction: The historical development of evidence-based medicine is interrelated with the development of scientific research and its implementation in medical practice. During this process, the scientific method was validated and the need for ethical controls is reinforced.

Objective: To review the historical development of evidence-based medicine and to emphasize on the bioethical implications for an adequate implementation in order to contribute to the improvement of medical sciences.

Methods: In the clinical implementation of evidence-based medicine, the level of scientific evidence during the assessment of literature is hierarchized, which helps professionals make clinical decisions. Focusing the implementation of a diagnostic means or a therapeutic measure according to the gradualness and quality of evidence with no more, under a vision rulingout moral values, the social context and the participation of patientsthemselves, as well as excluding the various social, cultural and economic obstacles, represents a gap existing during the isolated implementation of evidence-based medicine. At this point, bioethics is paramount; it must be conceptualized not only to protect the patient, but it must respond in the face of technological and scientific complexity.

Conclusions: Evidence-based medicine brings about higher quality of clinical practice and, at the same time, raises the need to assume ethics of patient care. It should be a practice that integrates the scientific with the axiological, conceptualizing evidence-based bioethics in health.