Evidence-Based Medicine (EBM)

While EBM directly tackles ethical questions related to the efficacy of psychiatric treatments, it largely ignores other major ethical debates in psychiatry, such as the debate concerning the validity of diagnosis. Instead, EBM assumes that psychiatric diagnoses are valid and focuses attention on which tools do a better or worse job of establishing diagnoses. [DSM behaviorist criteria and quantification through numerical scores on symptom rating scales] obscure the substantive question of whether a given diagnostic entity is a disease requiring medical intervention (Gupta, 284). . . . A final ethical issue in psychiatry that EBM is unlikely to resolve is the question of whether involuntary psychiatric treatment is legitimate. . . One must in troduce ethical considerations lying outside the utilitarian ethics of EBM, such as notions of human rights, to consider whether involuntary treatment is ethical (Gupta, 285). . . . advocates of an evidence-based approach to psychiatry . . . neglect to consider that, at best, EBM’s ethics can only address a limited set of ethical questions. As a result, EBM cannot, at least on its own, provide the ethical substantiation sought by some psychiatrists” (286).