With the potential to alleviate disease and ameliorate illness, and thereby to promote the conditions for
human flourishing, few human endeavors have the emancipatory potential of medicine. And yet, despite
being in the age of evidence-based practice, medicine has come increasingly under criticism as a
territorializing force exerting a kind of dehumanizing, colonizing pressure on patients and practitioners
alike. Overwhelmingly, these attacks lean on the work of philosophers like Heidegger, Foucault, and
Deleuze and Guattari. However, I contend this line of criticism fails on two fronts. First, it represents a
form of reductive ideological dogmatism that ignores facts on the ground – a rather ironic fact, since that
charge is one of the primary allegations made by this camp against evidence-based medicine (EBM).
Second, this line of attack hinges to a great extent on a consistent failure to recognize and appreciate the
distinction between EBM and biomedicine. This conflation leads to a host of unwarranted criticisms.
Disentangling EBM from biomedicine is an important and urgent task, therefore. When properly
disentangled, it becomes clear that charges of an inherent, pernicious reductivism leveled against EBM in
fact are aimed at pernicious features of biomedicine’s model of health. Evidence-based medicine is best
understood as a method, not a doctrine. As method, EBM is not intrinsically reductive. Yet, like any
method, it can be applied improperly, yielding reductive practices. As some have noted, pressures
exerted by medical management entities concerned primarily with fiscal bottom lines, as well as growing
fears of legal vulnerability on the part of practitioners inclined to deviate from established practice
guidelines in order to respect patient values and circumstances both exert reductive influences on
evidence-based practice. Far less well appreciated is that healthcare professionals’ interpretive
frameworks influence their practices, and, moreover, that the biomedical model represents the current
prevailing model of health. This is perhaps the most important reason why EBM and biomedicine must be
disentangled; in order for EBM to recover its emancipatory potential, it must liberate itself from the
biomedical model, and, further, it must develop an alternate model of health consistent not only with its
methodology, but with its values. In this endeavor pragmatism offers particularly rich resources.