While the benefits of evidence based medicine are widely recognised, the issue of ethics can be perceived as something of a stumbling block.
An Ethical Practice
In terms of supporting the ethical implications of evidence based care, it is true to say that patients receive treatment that is scientifically proven to be effective and are therefore receiving the best possible known treatment. In the long term, the concept of evidence based medicine aims to provide high quality patient care based on research that supports medical decision-making and research has suggested that patients who have been treated under this procedure have experienced better health in the long-term and suffered less pain.
Cost cutting is often at the centre of the debate surrounding the use of evidence based medicine, with many studies suggesting that cheaper treatments are favoured even when they are not the most effective available. This is also true of allocating research grants, with projects related to several illnesses not receiving the funding necessary to achieve progress with treatment.
Allocation of Treatment
Perhaps the most controversial element related to the application of evidence based medicine is associated with the allocation of treatments, which can differ significantly depending on which area a patient lives in. This is an issue that has received considerable media attention, with the provision of medication to treat cancer sufferers the most frequent case to hit the headlines. This however, is not a flaw in the theoretical concept of evidence based medicine but rather a political issue relating most commonly to economic viability and local Primary Care budgets.
Using Money Effectively
The NHS has a finite budget and the money available must be spent as effectively as possible; this is to say that, for example, there is a medication that can be used to treat thousands of patients at the same cost as funding one extremely complex surgical procedure, then the decision will be taken to proceed with the medication rather than the operation. If unfortunately, you happen to be the individual in need of the operation then this may seem unjust; however, if for the same amount of money, thousands of people could possibly be saved, this option must be taken. On a personal level the concept of evidence based medicine can seem unethical but on a wider, national and global level it makes more sense.
Evidence based medicine is often accused of negating individual patient choice in the sense that it tends to reflect the law of averages and therefore if you, as a patient, find that you are actually in favour of having a treatment that few other people choose, you would be more likely to be given the more popular alternative. Having said this, it must also be noted that being able to refer to solid evidence can be instrumental in explaining treatments to patients and, in turn, helping them making decisions with regard
to future care.