Amber Comer, PhD, JD, Affiliate Faculty at the IUCB recently published an article titled “Which Values Should Guide Evidence-Based Practice?” in the AMA Journal of Ethics. This article examines ethical considerations in evidence-based medicine (EBM) and its application to patient care. Utilizing the AMA Code of Medical Ethics as guidance, Comer considers challenges that physicians face when utilizing evidence in practice. This includes the balancing of the scientific basis of medicine and its practice as an art, handling patient requests for non-evidence-based therapies, and patient refusal of evidence-based medicine.
Comer makes the following recommendation to combat these challenges: 1) providers should consider evidence from clinical research, their clinical knowledge, and patient values when recommending treatment, 2) providers are not obligated to deliver care that will not, in their medical judgement, benefit the patient, and 3) clinician autonomy does not supersede the patient’s autonomy to refuse treatment even if it is life-saving.
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