Three Propositions for an Evidence-based Medical Anthropology

Medicine seems to collect evidence in ways entirely different from social anthropology. It aims to gather ‘best evidence’ through large randomized controlled trials (RCTs) and advanced methods of statistical analysis. The latest phase in this drive towards quantification is the global rise of evidence-based medicine (EBM). From the perspective of EBM, ethnographic evidence, with all its emphasis on ‘local’ knowledge, is at best anecdotal, at worst insignificant. Anthropological engagements with EBM have just begun, and much work – both empirically and conceptually – remains to be done. This paper takes up the challenge posed by EBM and develops three propositions for an ‘evidence-based medical anthropology’. The first proposition is that anthropologists have to study medical evidence-making differently than before. The second proposition is that EBM compels anthropologists to reconsider what they see as ‘evidence’. The third proposition reverses the analysis once more to suggest that anthropological evidence can discover fundamental blindspots in EBM. The examples presented here are drawn from research on treatments of depression by general physicians and psychiatrists in Kolkata (Calcutta, India).