EVIDENCE-BASED MEDICINE - WHY IS THIS A THING? (PART 5)

****Part 5: Shortcomings of EBM and and how Oswald's Spengler's views come to play

While evidence-based medicine has made significant contributions to the field of medicine, there are limitations that challenge its effectiveness. One of the limitations of evidence-based medicine is the narrow focus on empirical evidence. This limitation is especially evident in cases where there is a lack of high-quality evidence or where the available evidence is conflicting or inconclusive. In these cases, evidence-based medicine may not provide clear guidance for clinical decision-making.

Another limitation of evidence-based medicine is its failure to account for individual patient characteristics and preferences. Evidence-based medicine relies on population-level data and may not consider the unique circumstances of each patient. As a result, evidence-based medicine may not always provide the most appropriate treatment options for individual patients.

Finally, evidence-based medicine has been criticized for its reliance on quantitative data at the expense of qualitative data. While quantitative data is essential for assessing the efficacy and safety of medical interventions, qualitative data can provide valuable insights into patient experiences and preferences. Evidence-based medicine's focus on quantitative data may lead to a devaluation of patient-centered care and a lack of attention to patient experiences.

Oswald Spengler's philosophical views offer a way to address the limitations of evidence-based medicine. Spengler argued that Western civilization was characterized by a Faustian drive for knowledge and progress, which led to the domination of nature and the material world. However, Spengler also recognized that this Faustian drive had limitations and that there were other ways of knowing and understanding the world.

One of Spengler's key concepts was that of "Kultur" (culture). For Spengler, Kultur was a holistic understanding of the world that encompassed not only empirical knowledge but also artistic, spiritual, and philosophical knowledge. By embracing Kultur, evidence-based medicine could broaden its scope beyond empirical data and include patient experiences and preferences as well.

Spengler also emphasized the importance of individuality and the uniqueness of each person. This emphasis on individuality could help address the limitations of evidence-based medicine by acknowledging the importance of considering each patient's unique circumstances and preferences. By recognizing the importance of the individual patient, evidence-based medicine could move away from a one-size-fits-all approach and towards a more patient-centered approach.

Furthermore, Spengler argued that there were limits to knowledge and that not everything could be known through empirical means. This idea is particularly relevant to the limitations of evidence-based medicine in cases where there is a lack of high-quality evidence or where the available evidence is conflicting or inconclusive. By recognizing the limits of empirical knowledge, evidence-based medicine could become more open to alternative ways of knowing and understanding the world.

In addition, Spengler's emphasis on cultural pessimism and the decline of civilizations could provide a cautionary note for evidence-based medicine. Spengler argued that civilizations go through a life cycle of birth, growth, decline, and death. He believed that Western civilization was in the stage of decline, and that this decline was characterized by a loss of spiritual values and a focus on materialism. By recognizing the potential for decline, evidence-based medicine could become more reflective and self-critical, and work towards addressing its limitations and improving its effectiveness.

Overall, Oswald Spengler's philosophical views offer a way to address the limitations of evidence-based medicine and broaden its scope beyond empirical data. By embracing Spengler's ideas of Kultur, individuality, limits to knowledge, and cultural pessimism, evidence-based medicine could become more patient-centered, reflective, and self-critical.