Medical Uncertainty: Issues of Ethics and Evidence
Valerie Miké, Ph.D., is Clinical Professor of Biostatistics in Public Health and former Head of the Biostatistics Laboratory at the Sloan-Kettering Institute for Cancer Research.
Dr. Miké is engaged in research on ethical and value issues pertaining to uncertainty in biomedical science and technology, with emphasis on the role of statistical evidence in technology diffusion, clinical decision-making, and the formation of public policy. Collaborating with colleagues in pediatrics, she has developed case studies in perinatal medicine to explore factors important in the adoption of new technologies.
Dr. Miké has introduced the notion of an Ethics of Evidence, an approach for dealing with the uncertainties of medicine in the full context of contemporary culture. The Ethics of Evidence can be summed up in two simple rules or imperatives: The first imperative calls for the creation, dissemination, and use of the best possible scientific evidence as a basis for every phase of medical decision-making. Complementing it, the second imperative focuses on the need to increase awareness of, and come to terms with, the extent and ultimately irreducible nature of uncertainty--scientific and existential uncertainty. The Ethics of Evidence is a multidisciplinary concept, encompassing the wide range of factors affecting the practice of medicine.
Current research projects include:
- Further theoretical development of the Ethics of Evidence, applicable more broadly to human affairs.
- Development of case studies from the history of science and medicine, to enhance insight into contemporary issues.
- Completion of a book on chance and uncertainty in medicine, addressed to health care providers and the general public.
- Preparation of a series of articles for the Encyclopedia of Science, Technology, and Ethics.