Paper short abstract:

This paper examines meanings and forms of evidence and the search for legitimation in both international health policy and a local Indian medical tradition. It discusses ways to bridge problems of incommensurability between medical traditions in evaluating therapeutic effectiveness.

Paper long abstract:

This paper situates dominant contemporary understandings of how 'evidence' is understood in health policy and biomedical science in socio-historical context. It argues for a re-focusing of attention on the original impetus for introducing 'evidence-based' approaches to clinical practices, as a means to bridge fundamental problems of incommensurability between different medical traditions in regard to the evaluation of effectiveness. Drawing on secondary analysis of evidence-based medicine in Euro-America and ethnographic exploration of an 'experience-based' local therapeutic tradition in north India, the paper discusses differing forms and meanings of evidence, the search for legitimation and the role of practitioner expertise in judging therapeutic effectiveness. I propose a shift in focus from issues of methodological incompatibility to patient accountability and fairness of evaluation in both social science and biomedical construals of evidence.