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Medicines (Basel). 2018 Apr 25;5(2). pii: E40. doi: 10.3390/medicines5020040.

Rationalism, Empiricism, and Evidence-Based Medicine: A Call for a New Galenic Synthesis.

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Medical Scientist Training Program, University of Alabama at Birmingham, Birmingham, AL 35294, USA.


Thirty years after the rise of the evidence-based medicine (EBM) movement, formal training in philosophy remains poorly represented among medical students and their educators. In this paper, I argue that EBM’s reception in this context has resulted in a privileging of empiricism over rationalism in clinical reasoning with unintended consequences for medical practice. After a limited review of the history of medical epistemology, I argue that a solution to this problem can be found in the method of the 2nd-century Roman physician Galen, who brought empiricism and rationalism together in a synthesis anticipating the scientific method. Next, I review several of the problems that have been identified as resulting from a staunch commitment to empiricism in medical practice. Finally, I conclude that greater epistemological awareness in the medical community would precipitate a Galenic shift toward a more epistemically balanced, scientific approach to clinical research.


Galen; empiricism; epistemology; evidence-based medicine; medical education; rationalism

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