Absence of Evidence

Clinical decision-making requires critical thinking and is essential to forming a solid conclusion when evidence does not exist.

Consider the following question with your Learning Team:

  • On what do you rely in the absence of evidence?

Submit a 260-word initial response that includes at least one related article to support your position.

Respond to at least one team member’s post in 175 words.

Expert Solution Preview

Introduction:
In the field of medicine, making decisions and drawing conclusion requires critical thinking, especially when evidence is not present. Medical college students need to understand the importance of clinical decision-making, and how to approach making decisions that lack evidence. In this assignment, we will explore what a medical student should rely on in the absence of evidence.

Answer:
When faced with making clinical decisions in the absence of evidence, medical students must rely on a patient’s history, clinical judgement, and personal experience. This approach is known as the art of medicine and one of the components that make medicine such a dynamic field. In some cases, the medical student may need to rely on their instincts and make subjective or intuitive decisions, even when scientific evidence is unavailable. For example, a medical student may need to decide on the treatment of a patient suffering from a rare disease with no evidence-based treatment options. In these cases, the medical student relies on their skills to make decisions based on past experiences, other cases, and intuition to develop a sound treatment plan.

According to an article published in the Journal of Medicine and Philosophy, practitioners rely on two approaches when treating with no scientific evidence. These are the “evidential approach,” where they use the existing evidence despite the lack of context for the individual patient, and the “narrative approach,” where they construct a personalized story from the patient’s experience and symptoms. Thus, in the absence of evidence, medical students can rely on the narrative approach, as it emphasizes the patient’s experience, feelings and requires the practitioners to develop a closer relationship with them.

Response to team member’s post:
I agree with my colleague that personal experience is crucial when making decisions in the absence of evidence. In addition, a medical student must build strong relationships with the patient. In some cases, patient history and experience can provide valuable insight, which can lead to better decision-making, especially when evidence is not available. I would, therefore, advise my colleague not to overlook patient input in their quest to make decisions, particularly when working with rare diseases that lack evidence-based treatment. Medical students must always be willing to learn and improve their decision-making skills, especially when making judgments that require the art of medicine.

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