As medical professionals, we practice Evidence-Based Medicine (EBM). This means that when faced with a clinical question, we consult available evidence to make the best possible decision in the patient’s interest. Take, for example, in Orthopaedics; when we are faced with a fracture, the clinical question would be “Do I need surgery for this to heal well?” or “What implant is best suited for this fracture pattern?”. With this question in mind, we then search through databases such as Pubmed to gain knowledge on the clinical question to help us make a sound decision and not a random one. All spectrum of healthcare relies on EBM, from doctors to nurses to therapists, to ensure we make the best clinical decisions in our practice.
Is the practice of EBM rooted in God’s Word? The answer to this question has substantial implications for how we perceive EBM daily. It will either draw us nearer or further from God, depending on our understanding of EBM. As I pondered on this, I realized that this practice is a God-exalting one if viewed through the lens of scripture, and it is rooted in at least three vital biblical truths.
God’s creation is orderly
Paul exclaims in his letter to the Corinthian Church in 1Cor 14:33 that God is not a God of confusion but peace. Peace can only be found in orderliness, and we see that the world is orderly because God himself is orderly. This is also outlined in His creation from the beginning. In Psalms 104:19, the Psalmist says that God made the moon to mark the seasons, and the sun knows its time for setting. Such is the extent of his orderliness.
Orderliness is a presupposition that experiments and trials can be carried out. It is assumed and often taken for granted that things around us work in an orderly fashion. Force is always equal to mass x acceleration. It is not random. Mathematical constants such as gravitational constants are constants for a reason – they are constant and do not change.
It is this biblical reason that gives us the confidence to even engage in a study. We know that if we pass this drug to a patient, we expect it to work in an orderly manner, and we can tabulate the results to conclude its effectiveness. And we are confident that if we repeat the same experiment, we will get somewhat similar results because we already assume there is some order in this world.
God allows His Orderly Creation to be discovered
An orderly world does not mean that God must allow us to discover things. Having a pet dog in a tidy house does not mean it can figure out how to use the table lamp or to read the book. We take it for granted that God, in His mercy and grace, has availed to us the intelligence to comprehend, discover and harness the raw materials he has given us to create things. He has all prerogative to keep the knowledge to Himself. But not only did he give us an orderly world, but he also allowed us to discover and gain knowledge from it.
This is a fundamental reason why we can even engage in EBM. We now can discover drugs, materials to make implants that can be used to help human flourishing. Though our pets benefit from an orderly world, they are not given this ability to discover and invent things to help in their flourishing. The ability to explore and discover His orderly world is, itself, a gift that should not be taken for granted.
God allows His Orderly Creation to be Discovered to point to Himself
We know that God’s world is orderly. We know that He has allowed us to discover and invent things in His world. But why does he allow it? In other words, why does God allow for EBM to occur? Asking “why” will give us His purpose for EBM, and that is what we want to know.
The reason is that EBM is meant to point us to God because Paul says in Romans 1:20, that “God’s invisible attributes, namely, his eternal power and divine nature is revealed to us in the things that have been made”. So that “we are without excuse” to claim that God has not revealed to us enough of his amazing nature. If we agree with the fundamental truth that we do not have anything that is not given from God (1Cor 4:7, James 1:17), then we have to also agree that even knowledge in the realm of medicine is God’s. If we seem to possess some knowledge, albeit partial in nature, through EBM, it has to also have come from God. As such, we must humbly realize that any knowledge that we now have through EBM is meant to drive us to the giver. Merely frolicking in the gift of knowledge and using them in making decisions is not God’s desire for you and me.
The primary reason for EBM is to point us towards his glory and majesty (Psalms 19:1-2). The secondary reason for God giving us this knowledge is for us to point patients, as they benefit from us applying EBM, to God as the ultimate giver of medical knowledge. Ultimately, “the hand of the Lord has done all this and in His hand is the life of every living thing and the breath of all mankind” (Job 12:7-10). The gift of knowledge in EBM must drive us to the giver of the gift.
EBM is a practice firmly rooted in God’s word. As practising healthcare professionals, if we keep this in mind, we will see God in every journal club, case presentation, and lecture even when the presenter does not realize and proclaim it. Often, we ourselves neglect to proclaim this truth due to fear – this we have to repent and pray for boldness. Nevertheless, the next time you hear a scientific study being presented at a journal club, take your thoughts captive to Christ (2Cor 10:5). Remember that discussing that journal is only possible because of God’s orderly creation, His grace to allow us to discover it, with the purpose to draw us to Him and His people.
None of us deserves such grace, for we are all sinners. Such is the gratitude we must have, for the gift of EBM.
As with all good gifts God gives to us, it can and will be corrupted in the hands of humans. This reflection does not go into the details, but just as how the Bible itself, as a gift can be corrupted, so can EBM. This is the reason why we see corruption manifested in bribery of journal editors, statistic manipulation and biased studies funded by medical companies. We are victims and perpetuators of such corruption and thus we are always in need of His grace.