I. Introduction
Evidence-Based Medicine (EBM) is a relatively recent phenomenon. The term itself was not coined until 1991. It began with the best of intentions — to give frontline doctors the tools from clinical epidemiology to make science-based decisions that would improve patient outcomes. But over the last three decades, EBM has been hijacked by the pharmaceutical industry to serve the interests of shareholders rather than patients.
Today, EBM gives preference to epistemologies that favor corporate interests while instructing doctors to ignore other valid forms of knowledge and their own professional experience. This shift disempowers doctors and reduces patients to objects while concentrating power in the hands of pharmaceutical companies. EBM also leaves doctors ill-equipped to respond to the autism epidemic and unable to produce the sorts of paradigm-shifts that would be necessary to address this crisis.
In this article I will:
- provide a brief history of EBM;
- explain how evidence hierarchies work;
- explore ten general and technical criticisms of EBM and evidence hierarchies;
- examine the American Medical Association’s 2002, 2008, and 2015 evidence hierarchies;
- highlight the corporate takeover of EBM; and
- explore the implications of these dynamics for the autism epidemic.
Hellbound and Down 