Evidence based medicine and justice

A framework for looking at the impact of EBM upon vulnerable or disadvantage groups

Wendy A. Rogers*

*Corresponding author for this work

Research output: Contribution to journalArticle

81 Citations (Scopus)
6 Downloads (Pure)


This article examines the implicit promises of fairness in evidence based medicine (EBM), namely to avoid discrimination through objective processes, and to distribute effective treatments fairly. The relationship between EBM and vulnerable groups (such as those disadvantaged by virtue of poverty, ethnicity, age, gender, mental health problems or similar) is examined. Several aspects of EBM are explored: the way evidence is created (commissioning and design of, and participation in research), and the way evidence is applied in clinical care and health policy. This analysis suggests that EBM turns our attention away from social and cultural factors that influence health and focuses on a narrow biomedical and individualistic model of health. Those with the greatest burden of ill health are left disenfranchised, as there is little research that is relevant to them, there is poor access to treatments, and attention is diverted away from activities that might have a much greater impact on their health.

Original languageEnglish
Pages (from-to)141-145
Number of pages5
JournalJournal of Medical Ethics
Issue number2
Publication statusPublished - Apr 2004
Externally publishedYes

Bibliographical note

Copyright retained by the author(s). Article originally published in Journal of Medical Ethics, Vol. 30, Issue 2, pp.141-145. The original article can be found at http://dx.doi.org/10.1136/jme.2003.007062. Article archived for private and non-commercial use with the permission of the author and according to publisher conditions. For further information see http://www.bmj.com/

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