Ethical questions in evidenced based medicine and evidence based management: The value of practice oriented education

A growing reliance on allegedly impartial “evidenced based” approaches to medical and managerial decision-making has potentially serious ethical consequences capable of undermining stakeholder trust and compromising professional conduct. By its nature, dispassionate bottom-line reductionism cannot provide a holistic or normative view of the patient, the customer, the employee or any participating or affected moral agent. As medical school students dissect their cadavers or interact with patients few express more than a detached concern for the bodies on which they practice. As business school students “dissect” their cases or engage in field research far fewer contemplate anything more than the technocratic dimensions and financial ramifications of the problem. Effectively addressing real complexity in medicine or management can only come from appreciating that what is measurable or testable may be of least likely importance. These lessons are best learned through practice oriented education based upon a normative model of ethical learning that stresses value and meaning. Such a model for future physician executives is being implemented through a partnership between Tufts Medical School, Northeastern University, Brandeis University, and the Cambridge Health Alliance (a regional public health care institution) in the summer of 2007.