Читать книгу Pet-Specific Care for the Veterinary Team - Группа авторов - Страница 100

In the absence of EBVM practices, clinicians typically base their decisions on sources of evidence other than scientific research, especially the opinions of colleagues and perceived experts. When clinicians do use research findings to guide their practice, this involves an informal, haphazard consultation of textbooks, journal articles and other sources, often without critical assessment for bias. Veterinarians often rely most heavily on their own experience and intuition in making patient care decisions. This collection of strategies is referred to as opinion‐based medicine.

Unfortunately, personal experience, even that of highly trained and experienced individuals, is subject to many cognitive biases and other sources of error that make it less reliable than is generally believed. Such biases lead to erroneous conclusions which undermine the safety and efficacy of medical interventions. The success of modern, science‐based medicine in reducing suffering and improving health rests mostly on shifting reliance away from idiosyncratic personal observations and opinion and toward formal scientific research evidence.

We cannot provide effective pet‐specific care without reliable information. We cannot assess health risks without understanding the causes of illness and the relationship between risk factors and health outcomes. We cannot provide effective preventive or therapeutic interventions without evidence showing which methods are effective and which are not. We cannot minimize the adverse effects of our treatments without understanding what the risks are and why they occur. EBVM makes effective care possible by generating the needed information and helping clinicians find and use it.

Evidence‐based veterinary medicine is also useful in meeting our ethical obligations to pet owners. These include not only providing the most effective care possible but also obtaining informed consent for our interventions. When we recommend a treatment to a pet owner using an evidence‐based approach, we can confidently identify the potential risks and benefits of the treatment and the degree of uncertainty about these based on reliable scientific information, rather than anecdote or opinion. We will not always be certain about the outcome, but we can give an informed estimate of the degree of uncertainty. This is an important element in gaining informed consent from clients.

Pet owners have an ethical and often a legal right to be informed about the possible risks and benefits of medical interventions. EBVM helps veterinarians fulfill our ethical obligations to clients by ensuring that the information we provide is as accurate and reliable as possible. Even when the evidence is limited and the level of uncertainty is high, as is often the case in veterinary medicine, EBVM helps the clinician to be transparent about this with pet owners and to provide the information needed for fully informed consent.