Thursday, May 05, 2005

Evidence Based Public Policy

In the field of medicine, a great deal of attention has been paid in recent years to evidence-based or science-based medicine, in which doctors attempt to apply the following steps to medical diagnosis and treatment:
  1. Accurately define the medical condition;
  2. Investigate the medical literature, ferreting out that which is scientifically valid and clinically relevant; and
  3. Apply the best available evidence and science to treatment of the medical condition.
This approach is not perfect, and counter-arguments include the allegation that it underestimates the value of clinical experience, and that it can be misleading to apply epidemiological techniques to diagnosing and treating the conditions of individual patients. Also, as the available evidence may be insufficient, it may be premature to attempt to discern an evidence-based solution. But, whatever the drawbacks, significant advances can result from the application of evidence-based medicine, and from the aggregation of data which can be used to evaluate and improve the efficacies of various treatments in particular populations of patient.

In our nation, we ostensibly have a federal system, where states are free to experiment with their own solutions to problems, and where the good solutions can be emulated by other states. The reality, it seems, is a bit different, with state legislatures often seeming inclined to jump on a public policy bandwagon rather than looking at what in fact works, and the federal government finding a variety of means to impose its will on the states. And significant changes in public policy often result not from evidence of what might work better, but from raw political ideology.

Now, whether or not they are willing to admit it, everybody has prejudices and political perspectives which color their opinions on various issues of public policy. But what is more important? Being true to a political ideology, or finding the best possible solution for a public policy issue? Too often, our nation seems to prioritize ideology. I think it is long past time we focused on the science and evidence, and where inadequate that we focus on improving the body evidence and scientific knowledge we require to form the best solution. Granted, it is easier to shortcut the thinking process by declaring your ideology as a sufficient reason to support or oppose a particular policy. But if you have to experiment on society, I would rather turn to the evidence.

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