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Ethics, philosophy, and evidence based medicine
  1. R Ashcroft1,
  2. R ter Meulen2
  1. 1Medical Ethics Unit, Imperial College, London, UK
  2. 2Institute for Health Care Ethics, University of Maastricht, the Netherlands
  1. Correspondence to:
 R E Ashcroft
 Imperial College London, Department of Primary Health Care and General Practice, Reynolds Building, St Dunstan’s Road, London W6 8RP, UK;

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The editors of the symposium hope it will provide a balanced appraisal of evidence based medicine.

This symposium is devoted to evidence based medicine (EBM) and the ethical issues it raises. Since Sir Archie Cochrane’s seminal Nuffield Provincial Hospitals Trust lectures in 1972 and their publication as the Rock Carling monograph for that year, Effectiveness and Efficiency: Random Reflections on Health Services, the idea that medical interventions and health services should be evaluated and selected on the basis of the most reliable evidence available for their effectiveness and cost effectiveness has become very widely accepted.1,2 This widespread acceptance has not been complete, and it sometimes seems that there are as many critics of EBM as advocates. Whereas the importance of randomised trial evidence, critical appraisal, meta-analysis, and systematic review …

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