The CauseHealth Series: Chapter 6 - The Guidelines Challenge with Dr Samantha Copeland


Welcome to another episode of the Words Matter Podcast.

We continue our journey into the CauseHealth book, and this time talking again to Dr Samantha Copeland about Chapter 6 (see chapter 6 here), which is titled ‘The Guidelines Challenge’. Chapter 6 closes Part 1 of the book, the Philosophical Framework, and the next episode represents Part 2, the Clinical Application, where quite rightly, I’ll be speaking with Christine Price about her experience as a patient, of complexity and her persistent pain (see all episodes of the CauseHealth Series here).

In this episode we talk about:

  • The original aims and purpose of clinical guidelines, and how they were developed to operationalise evidence-based practice.
  • The ontological and epistemological assumptions around causation that are built into guidelines.
  • The tension between evidence based guidelines and a dispositional view of causality for understanding health, disease, and the effectiveness (or not) of medical Interventions.
  • The sorts of evidence (methods) which make up guidelines and what is the problem/conflict here when practitioners implement these to individual patients.
  • How guidelines should be developed to account for the particulars of individual patients? (not just methodological pluralism but a revised ontology of causation).
  • How guidelines should be utilised or viewed by clinicians.
  • The integration of guidelines with expertise, judgement, decision-making
  • Finally, we talk about Lessons learned from Oxford ‘Guideline Challenge’ conference, and in the show notes have linked a editorial paper by Samantha and colleagues (see here) which outlined the major problems and positions presented in relation to guidelines, and how dispostionalist theory might provide some solutions to enable the better development and utilisation of guidelines for person-centred care.

So this episode has it all; EBM, clinical reasoning, judgment, ethics and even AI. Samantha does a fantastic job in articulating hers and the CauseHealth’s vision of guidelines. 

Find Samantha on Twitter @samdotC

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