ABSTRACT
Evidence-based medicine (EBM) is defined as the conscious and judicious use of current best evidence in making decisions about the care of individual patients. A greater level of evidence implies a higher recommendation grade. This concept of EBM is embedded in a particular view of medical practice, that is, the singular nature of the patient–physician relationship. The massive medical research globally with doubtful scientific validity and systematic breaches in professional integrity are at the core of EBM.
Nevertheless, EBM appears to be reinterpreted considering the scarcity of healthcare resources. Although EBM should be a guideline for clinical practice, it can be a useful tool for the macro-allocation of healthcare resources. The methodology described in Norman Daniels’ theory of public accountability is used to justify this assumption: choices in healthcare must be accounted for by democratic procedures.
This perspective of distributive justice is responsible for the scope and limits of healthcare services. Entitlements to healthcare, namely expensive and innovative treatments and medicines, may be fairly restricted as long as this decision is publicly accountable and imposed by the system’s financial restrictions. Then, EBM’s usage is regarded as a tool to facilitate each citizen’s access to an appropriate healthcare level.
