The Evidence-Based Approach to Medicine and the Commodification of Health Care Services

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According to one definition, evidence based medicine "involves the delivery of optimal individual patient care through the integration of current best evidence on pathophysiological knowledge, cost effectiveness, and patient preferences." In essence, evidence based medicine is rooted in the following central conceptions: clinical decisions should be grounded on the best available scientific evidence; identifying the best evidence means using epidemiological and biostatistical ways of thinking; and this evidence should guide medical practice. Evidence-based medicine emerged in the context of reforms of health care services worldwide that shared the growing commodification of health care. Using Foucault's idea of governmentality as a "rationality of government", this paper argues that evidence-based medicine is not only an approach which optimizes the quality of care patients receive but, with its emphasis on cost-effectiveness and its positivistic approach to rationality and science, it functions as one of the intellectual strategies that allow for the acceptance among health care providers of the logic of commodification processes. The paper begins by discussing evidence-based medicine epistemological assumptions and the ways it influences clinical practice. In its second section it analyzes the main characteristics of neo-liberal health care reforms and finally it shows in which ways the evidence-based approach functions as part of a neo-liberal governmentality.


Keywords: Medicine, Health Care
Stream: Natural, Environmental and Health Sciences
Presentation Type: Paper Presentation in English
Paper: A paper has not yet been submitted.


Dr. Dani Filc

Senior Lecturer, Department of Politics and Government, Ben Gurion University
Tel Aviv, Israel

Dani Filc, MD, PhD. Born 1959. Chairperson of Physicians for Human Rights-Israel Among his publications the books The Power of Property: Israel in the Globalization Age, edited with Uri Ram (Van Leer Institute Heb.), Hegemony and Populism in Israel (Resling, Hebrew), Contested Science: environment, public health and politics in Israel, edited with Nadav Davidovitch (Babel, Hebrew, forthcoming). Among articles published in refereed journals: “The Check-Post, Sovereignty and the Body”, Hagar 6(2) July 2006:99-113; "The 'Enterprization' of the Israel Health Care System", Critical Public Health (forthcoming); "Hamas and the Destruction of Risk Society", Constellations 12(4), November 2005, 544-562 (with N.Gordon); “Neo-liberalism and the Health Business: the Case of Israel”, Critical Social Policy, 25(2), 180-197, May 2005; "The National Unity Party: From Messianic Nationalism to Radical Right Populism", Mediterranean Politics, 10(1), 85-97, March 2005; Filc D., “The Contradictory Trends of Health Commodification in Israel”, Journal of Social Policy, 33(3), 417-436, July 2004.

Dr. Nadav Davidovitch

Senior Lecturer, Divion of Public Health, Ben Gurion University
Beer Sheva, Israel

Nadav Davidovitch, MD, MPH, PhD, is a senior lecturer in the Department of Health Systems Management at Ben Gurion University. Currently, he is researching health and immigration, environmental health, and the development of public health institutions and policies in Israel.

Ref: I08P0317