SPPH 581T 001 (Seminar) Ethics of Evidence – Based Medicine and Public Health – Term 1

Instructor: Daniel Steel
Section: 001

Term: 1
Meets: Monday 9:00 am-12:00 pm, School of Population and Public Health B138

Course Description

Since the early 1990s, Evidence-Based Medicine (EBM) has emerged as a highly influential movement that has impacted almost all health related disciplines, including population and public health. At the core of EBM is a set of beliefs about what constitutes good evidence for the effectiveness of health interventions. Consequently, it is an excellent example of what some philosophers refer to as a coupled ethical-epistemic issue. That is, what makes something good evidence for the effectiveness of a health intervention is not only a scientific or statistical question, but is also linked to the deeply value-laden aim of improving health in both clinical and population settings. This course, then, focuses on coupled ethical-epistemic issues arising from EBM, and their implications for population and public health. Specific topics to be addressed include:

  • Ethical and value aspects of the concept of evidence.
  • Potential rationales and shortcomings of evidence hierarchies commonly used in EBM.
  • The role of evidence-based approaches in population health, wherein randomized clinical trials are often infeasible.
  • Susceptibility of EBM approaches to phenomena such as sponsorship bias and disease mongering, and approaches for countering these.

Text

Jeremy Howick, The Philosophy of Evidence-Based Medicine, Wiley-Blackwell, 2011.

Course Objectives
A successful student in this course will:

  • Gain knowledge of major positions, concepts, and approaches the in philosophy of EBM, and their relevance to population and public health.
  • Improve critical reasoning, writing, and presentation abilities, and especially their ability to write a research paper that addresses philosophical issues related to population and public health.
  • Be able to provide ethically and philosophically informed reasons for decisions about how to apply concepts from EBM to cases from population and public health.