ABSTRACT
Evidence-based practice is an approach to the evaluation and application of research evidence to clinical practice. While it is difficult to identify a specific point of origin, most authors locate it in the work of the British epidemiologist Archie Cochrane. Cochrane proposed that healthcare resources should be used to deliver interventions and services that well-designed evaluations had shown to be effective
The aim of the chapter is to identify and explore some of the frequently unexamined moral and ethical assumptions that lie at the heart of evidence based practice (EBP) and which are inextricable from the ways in which evidence and the evidence hierarchy are conceptualised. Adopting an EBP approach gives rise to complex challenges in squaring the need to make the best use of scarce resources, avoid useless or dangerous interventions and deliver optimal care while not losing site of the complex needs of individuals. Healthcare practitioners need to draw on moral philosophy and ethical principles as well as research expertise when making decisions regarding interventions. While EBP acknowledges the importance of attending to unique values and circumstances of individuals ways of making this more central to the practice of EBP need to be identified and developed.
