https://onlinelibrary.wiley.com/doi/pdf/10.1111/jep.13010
Free full text
Sietse Wieringa MSc DPhil Student, Scientia Research Fellow1,2 Eivind Engebretsen PhD, Professor1, Kristin Heggen, PhD, Professor1,
Trish Greenhalgh PhD, Professor3
In modern philosophy, the concept of truth has been problematized from different angles, yet in evidence‐based health care (EBHC), it continues to operate hidden and almost undisputed through the linked concept of “bias.” To prevent unwarranted relativism and make better inferences in clinical practice, clinicians may benefit from a closer analysis of existing assumptions about truth, validity, and reality.
We draw on Belgian philosopher Isabelle Stengers' work to demonstrate that bias means one thing if one assumes a world of hard facts “out there,” waiting to be col- lected. It means something different if one takes a critical view of the knowledge‐ power complex in research trials. Bias appears to have both an unproductive aspect and a productive aspect as argued by Stengers and others: Facts are not absolute but result from an interest, or interesse: a bias towards a certain line of questioning that cannot be eliminated.
The duality that Stengers' view invokes draws attention to and challenges the assumptions underlying the ideal limit theory of truth in several ways. Most impor- tantly, it casts doubt on the ideal limit theory as it applies to the single case scenario of the clinical encounter, the cornerstone of EBHC. To the extent that the goal of EBHC is to support inferencing in the clinical encounter, then the ideal limit as the sole concept of truth appears to be conceptually insufficient. We contend that EBHC could usefully incorporate a more pluralist understanding of truth and bias and pro- vide an example how this would work out in a clinical scenario.
KEYWORDS
epistemology, evidence‐based medicine, practical reasoning, science
Free full text
Sietse Wieringa MSc DPhil Student, Scientia Research Fellow1,2 Eivind Engebretsen PhD, Professor1, Kristin Heggen, PhD, Professor1,
Trish Greenhalgh PhD, Professor3
In modern philosophy, the concept of truth has been problematized from different angles, yet in evidence‐based health care (EBHC), it continues to operate hidden and almost undisputed through the linked concept of “bias.” To prevent unwarranted relativism and make better inferences in clinical practice, clinicians may benefit from a closer analysis of existing assumptions about truth, validity, and reality.
We draw on Belgian philosopher Isabelle Stengers' work to demonstrate that bias means one thing if one assumes a world of hard facts “out there,” waiting to be col- lected. It means something different if one takes a critical view of the knowledge‐ power complex in research trials. Bias appears to have both an unproductive aspect and a productive aspect as argued by Stengers and others: Facts are not absolute but result from an interest, or interesse: a bias towards a certain line of questioning that cannot be eliminated.
The duality that Stengers' view invokes draws attention to and challenges the assumptions underlying the ideal limit theory of truth in several ways. Most impor- tantly, it casts doubt on the ideal limit theory as it applies to the single case scenario of the clinical encounter, the cornerstone of EBHC. To the extent that the goal of EBHC is to support inferencing in the clinical encounter, then the ideal limit as the sole concept of truth appears to be conceptually insufficient. We contend that EBHC could usefully incorporate a more pluralist understanding of truth and bias and pro- vide an example how this would work out in a clinical scenario.
KEYWORDS
epistemology, evidence‐based medicine, practical reasoning, science