Wheres the Evidence?: Debates in Modern Medicine

Paperback | April 15, 1999

byWilliam A. SilvermanForeword byDavid L. Sackett

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The essays in Where's the Evidence? focus on problems ignored. This book is a unique collection of critical andw controversial essays on intractable ethical issues and evidence-based problems in modern medicine. Most, but notr therapeutic disasters. Although it is impossible to prevent allmissteps in medicine, the author argues, a hedging strategy using concurrent controls when new therapies are introduced always reduces the number of patients killed or injured. It is dangerous to use treatments widely, he warns, before they are subject to rigorous comparative trials. Additionally,the author points out, questions have emerged about how to wield medicine's new capabilities wisely. How do we draw the line,' he asks 'between "knowing" (the acquisition of new medical information) and "doing" (the application of that new knowledge). What are the long- term consequences (moral,social, economic, and biological) of responding to a demand that medicine always do everything that can be done?' This book now issued in paperback is a collection of critical and controversial essays discussing intractable ethical issues and evidence-based problems in modern medicine. The essaystogether with responses were published over a ten-year period in the journal Paediatric and Perinatal Medicine. Most of the examples, but not all are taken from perinatal medicine, the field in which the author has worked for many years. The essays are thought provoking and will be of great interestto those involved in the ongoing evidence-based medicine debate. (See selected reviews)

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The essays in Where's the Evidence? focus on problems ignored. This book is a unique collection of critical andw controversial essays on intractable ethical issues and evidence-based problems in modern medicine. Most, but notr therapeutic disasters. Although it is impossible to prevent allmissteps in medicine, the author argues, a hed...

William A. Silverman is at Columbia University.

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Format:PaperbackPublished:April 15, 1999Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0192630881

ISBN - 13:9780192630889

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Table of Contents

Foreword by David L. SackettPrefaceList of RespondentsIntroduction1. Selective ethics2. Does a difference make a difference3. Prescription for disaster4. Therapeutic mystique5. Humane limits6. Intruding in private tragedies7. The glut of information8. Betting on specified horses9. Begin with 'if...'10. Archie's scepticism11. Arbitrary vs discretionary decisions12. Bioengineering13. '...disavowing the tree'14. Diffusing responsibility Weil's reply15. Hawthorne effects16. Power plays17. Unbridled enthusiasm18. Caring and curing19. On the edge20. Informing and consenting Weil's reply21. Lifesavers22. Belief and disbelief23. Preferences24. Bradford Hill's doubts25. More-informative abstracts26. Pain control in neonates27. Miraculous cures28. Observer bias29. The gamekeeper's brouhaha30. Champing at the bit31. Piecemeal skirmishes32. Resolution of dilemma's Sinclair and Fowlie's reply Watts and Saigal's reply33. 'Fixing' human reproduction34. Justice defined as fairness35. 'Methods-based' reviews36. Non-replication of the replicable37. Who defines 'futility' Goldworth and Benitz's reply38. Fitting targets in holes39. Medical 'manners' on trial40. Sanction of whose beliefs and values?41. Mindness existence42. Interventions on an unprecedented scale43. Preoccupation with 'autonomy'44. A 'win' in medical Russian Roulette Lantos' replyCitationsBibliographyIndex

Editorial Reviews

`'Where's the evidence? published by Oxford University Press, contains 45 essays which first appeared in Paediatric and Epidemiology, brought up to date with current comments and annotation, some by the author and some by other experts. To open a page and start reading is to beenthralled...Silverman takes up difficult problems. He does not always solve them, but he does offer challenging and sometimes unconvential points of view...Do obtain a copy, dip into it, and enjoy yourself while you stretch your mind.''Avrum Katcher, American Academy of Paediatrics Senior Bulletin August 1999.