This chapter introduces radical empiricism and pragmatism as the scientific basis for the politics of real life decisions about healthcare policy. Their use explains the paradox by which destructive forms of care are commissioned whilst their harmful consequences are, nonetheless, treated as irrelevant. The role of scientific empiricism during the twentieth century, or positivism, is described within the western European political-economic context as changing from a force to prevent ideological totalitarianism to a force enabling neoliberalism.
Radical empiricism is described as the scientific basis for an implicit and unacknowledged neoliberal pragmatism that subverts the social democratic aspirations of EBHC. This permits powerful experts, specialists and elites to distort and employ the ‘evidence’ of EBHC’s logical empiricism to limitlessly expand innovative forms of anticipatory care regardless of its collateral iatrogenic harms.
The chapter shows that what really decides best healthcare practice is an elitist and subjective process consistent with a philosophy of knowing called radical empiricism. And, so, the praxis of EBHC is not, as is taught to healthcare scientists, students and providers, provided by the apparently objective and social democratic logical empiricism of classical Evidence Based Medicine.