Evidence-Based Medicine: an Evolutionary Apprisal

This article is an evolutionary defense of Evidence-Based Medicine (EBM), which is an approach to medicine that considers researches published in reputable medical journals as the main basis of therapeutic interventions. In this approach, physician’s personal experiences and her intuition, and mechanical explanations for medical interventions are deemphasized. Since the advent of EBM, many criticisms have been made on it. Two of them will be mentioned in this article. First, it has been claimed that the replication crisis is a threat for EBM. Second, according to critics, EBM is based on a kind of extreme empiricism, while there are many criticisms for this kind of empiricism. From an evolutionary point of view some rejoinders have been offered to these criticisms. We will also see how to update the theoretical foundations of EBM in the light of these criticisms. In this regard, a defense is presented that in two cases, medical implications can be carried out rationalistically, that is, by considering general medical theories: first, to abandon or ignore any "seemingly" harmless medical advice; and two, by rejecting unqualified articles. At the end, it is mentioned that although by doing so we may reduce the speed of new data entrance in medicine, but from an evolutionary point of view, this level of conservatism is necessary to maintain the credibility of medicine.