The Ethic of Responsibility: Max Weber’s Verstehen and Evidence-Based Clinical Reasoning

• In Event: 343 - Section on Medical Sociology Roundtables (one-hour)
  In Refereed Roundtable: Table 04. Clinical Decision Making

Abstract

Evidence-based medicine (EBM) encourages the translation of medical research into practice through clinical practice guidelines (CPGs). I draw on Weber’s analysis of formal and substantive rationality to raise questions about the ethics of clinical decision making and CPGs, as articulated by the principles of EBM. I provide an original critique that moves beyond the standard sociological prognosis of the limitations of “the medical model” and argue that clinical decisions require alternative modes of reasoning, such as Weber’s method of sympathetic understanding (verstehen). To do so, I examine Codes of Ethics from Canada, the United States, and the United Kingdom that have emerged since the first statements of EBM. I engage with Weber’s political sociology and his concept “the ethic of responsibility” in order to reformulate the relationship between the physician and the patient. I propose verstehen as a new model of clinical reasoning that reformulates the relationship between medical knowledge and values. My model recognizes heterogeneous forms of knowledge, reasoning, and modes of understanding in contemporary clinical care, by demonstrating that the classical sociological cannon is relevant to contemporary health policy.

Author

• Ariane Hanemaayer, Dalhousie University