Dr. Sackett & "Mr. Sacketeer"... Encanto e desencanto no reino da expertise na medicina baseada em evidências

Abstract

In May 2000, Prof. David L. Sackett, one of the founders of the evidence-based medicine movement (EBM), published an article in the British Medical Journal in which he renounced writing, teaching, or serving as a referee for topics related to EBM. He justified his stance based on his frustration over what he considered the harmful effects of an alleged excess of experts in this field. Sackett's position was the raw material whereby we approached aspects linked to the definition and scope of EBM as well as related critiques. We also stress the movement's various rhetorical strategies. In addition, we discuss both the notion of expertise and the role of "expert systems" and "specialized competence" in our societal milieu, developed respectively by Anthony Giddens and Zygmunt Bauman. The main focus of this commentary is to emphasize that while we are dealing with a progressive trend towards acquiring control and intelligibility vis-à-vis the objects of our research, we must consider the possibility of dimensions that cannot be reached by way of the rationalistic Western mode of thought.

Máquinas y arte-sanos

“…Se plantea así un dilema entre "intereses económicos y valores sociales" (103) . Las preocupaciones de Arnold Relman se confirman en publicaciones posteriores que señalan cómo el interés económico desplaza la preocupación por la salud, y cómo la producción de conocimientos se realiza transformando a los individuos y/o poblaciones en objetos a través de ensayos clínicos, que se utilizan luego como evidencias científicas (104,105,106,107,108) .…”

Epidemia de fitness

“…This set of information chases away the specter of uncertainty, favoring the image of an effective product and thereby assuring the truth/ reality of the narrative (Bauman, 1999;Castiel and Povoa, 2001).…”

Tradução e adaptação cultural do global appraisal of individual needs - initial

“…For example, in S1 the term liberdade condicional appeared various mes, where the term currently used in Brazil (and equivalent to the North American term) is livramento condicional 3 (c) .…”

“…In view of this, the authors suggest greater investment in new care prac ces, with special a en on given to evidence-based prac ces (2)(3)(4)(5)(6) .…”