Analysis and Comment

Evidence based medicine

Analogies between reading of medical and religious texts

BMJ 2006; 333 doi: 10.1136/bmj.38966.487350.68 (Published 16 November 2006)
Cite this as: BMJ 2006;333:1068

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  1. Matthew Links, director
  1. 1Cancer Care Centre, University of New South Wales Clinical School, St George Hospital, Kogarah, NSW 2217, Australia
  1. Matthew.Links{at}sesiahs.health.nsw.gov.au
  • Accepted 25 August 2006

Whether you take a fundamental or liberal view of scientific evidence will affect how you interpret it. But just as with religion, we need to admit there will be legitimate differences in our views

Conventional medicine can be seen as a belief system characterised by a profession of faith in evidence based medicine.1 Faith in evidence based medicine follows from the benefits it has delivered in the past and continues to deliver. It is the best method we have for navigating our way through potential new treatments.1

Evidence based medicine, analogous to many religious traditions, is a system for the interpretation of a canon of sacred texts (medical literature). Differences in interpretation can often be traced to different assumptions underlying our reading of the literature. Just as there are fundamentalist, conservative, and liberal views of religious texts there are similar views of evidence based medicine. An examination of these views and assumptions can tell us much about differences in medical opinion.

Religious fundamentalism

The Oxford dictionary defines fundamentalism as the strict maintenance of the ancient or fundamental doctrines of any religion or ideology.2 Fundamentalism sees truth as unified, revealed, absolute, and inerrant. Supporters have a black and white view, seeing themselves as the true keepers of the faith with good reason for an absolute belief that they are right. Critics see the world in shades of grey and view fundamentalism as self righteous and simplistic.

Fundamentalism is associated with literal readings of sacred texts. Texts can be interpreted in different ways. A liberal reading of biblical prohibitions of homosexuality, for example, might consider that they do not apply to contemporary committed same sex relationships. Thus people with the same basic belief system, reading the same text, can come to radically different conclusions. These differences derive from the varying assumptions …

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