ETHICAL ISSUES IN EVIDENCE-BASED PRACTICE

Evidence-based medicine (EBM) or evidence based practice (EBP), is the

judicious use of the best current evidence in making decisions about the care of the
individual patient.

Evidence: It is something that furnishes proof or testimony or something legally

submitted to ascertain in the truth of matter.
Evidence-based practice: It is systemic inter connecting of scientifically generated
evidence with the tacit knowledge of the expert practitioner to achieve a change in a
particular practice for the benefit of a well- defined client / patient group. (French
1999).
Evidence-based nursing: it is a process by which nurses make clinical decisions
using the best available research evidence, their clinical expertise and patient
preferences (mulhall, 1998).
Evidence-based medicine or practice: The conscientious, explicit and judicious use
of current best evidence in making decision about the care of individual patient (Dr.
David Sackett, Rosenberg, 1996).

EBP in nursing is a way of providing nursing care that is guided by the

integration of the best available scientific knowledge with nursing expertise. This
approach requires nurses to critically assess relevant scientific data or research
evidence and to implement high quality interventions for their nursing practice. (NLM
PubMed)

ETHICAL ISSUES

Moral principles such as truth, fairness, and respecting autonomy lie at the heart
of these ethical concerns

Evidence based practice focuses on searching and appraising available evidence on

the advantages and disadvantages of various interventions. Ethical issues Include:
Status of evidence
Available evidence in health care areas consists mostly of expert
opinions where despite important advances in research, only few have
amassed sufficient data to enable research-based confidence in treatment
interventions
Client Autonomy
Patient and family participation in planning intervention (autonomy) is
an important dimension of rehabilitation. This participation should also
include decision making under difficult circumstances by the client when
competing interests are decided.
Conflict of Interest
May be represented when clinical trials are subjected to questions
about the validity of their conclusions. Although studies designed with
 high levels of control for competing hypotheses are emphasized as
necessary for achieving valid conclusions, the ethical threats involved in
conducting such research are sometimes understated. Again, scientists
rather than patients mostly determine decisions about who participates in
studies and whether intervention continues, thus creating a conflict of
interest. This may also lead to bias tendencies which may affect the
client’s autonomy.
Informed consent
The idea of informed consent is again grounded in the principle of
autonomy. This principle respects the right of a person to weigh the pros
and cons of a decision and to make a choice on the basis of his or her
consideration of alternatives. To make a fully informed choice, potential
participants must be advised of the expected benefits and risks.

- Ethical issues are a natural part of the health care community, they represent
themselves in the form of ethical dilemmas in clinical decisions.
- From a moral and professional standpoint, the dangers of not attending to evidence
are just as significant as the ethical issues attending to its application.

REFERENCES:

1. https://www.slideshare.net/pramodkumarsikarawar/evidence-based-practice-
66624987
2. Christiansen, C. & Lou, J. (2001). American Journal of Occupational Therapy, Vol. 55,
345-349. https://doi.org/10.5014/ajot.55.3.345