Introduction

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. For example, in Orthopaedics, when we encounter a fracture, we may ask ourselves "Do I need surgery for this to heal properly?" or "What implant is best suited for this type of fracture?" With these questions in mind, we search through databases such as Pubmed to gain knowledge on the clinical question and help us make a sound decision based on evidence rather than chance. All healthcare practitioners, from doctors to nurses to therapists, rely on EBM to ensure that we make the best clinical decisions for our patients.

Is the practice of EBM rooted in God's Word? This question has substantial implications for how we perceive EBM on a daily basis. Our understanding of EBM will either draw us nearer or further from God. As I pondered this question, I realized that this practice is God-exalting if viewed through the lens of scripture, and it is rooted in at least three vital biblical truths.

1. God's creation is orderly

Paul declares in his letter to the Corinthian Church in 1Cor 14:33 that God is a God of peace, not confusion. Orderliness brings about peace, and we see that the world is orderly because God himself is. This is also evident in his creation from the beginning. According to Psalms 104:19, God made the moon to mark the seasons, and the sun knows when to set. Such is the extent of his orderliness.

Orderliness is a necessary assumption for conducting experiments and trials. We often take for granted that things around us work in an orderly way. Force equals mass times acceleration, and it is not random. Mathematical constants, such as gravitational constants, are constant for a reason - they do not change.

It is the biblical reason that gives us the confidence to engage in scientific studies. We understand that if we administer a drug to a patient, we expect it to work consistently, and we can analyze the results to determine its effectiveness. Furthermore, we are confident that if we repeat the same experiment, we will obtain similar results because we assume that there is order in the world.

2. 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.

3. God allows His Orderly Creation to be Discovered to point to Himself

We know that God's world is orderly and that He has allowed us to discover and invent things within it. But why does He allow it? Specifically, why does He allow for evidence-based medicine (EBM) to exist? By asking "why," we can better understand His purpose for EBM, which is what we want to know.

The reason for Evidence-Based Medicine (EBM) is to point us towards God. In Romans 1:20, Paul states that "God's invisible attributes, namely, his eternal power and divine nature, are revealed to us in the things that have been made". Therefore, we cannot claim that God has not revealed enough of his amazing nature to us, and we are without excuse. If we accept the fundamental truth that we do not have anything that has not been given by God (1 Corinthians 4:7, James 1:17), we must also acknowledge that even knowledge in the field of medicine comes from God.

Any knowledge we possess, even if it is partial and gained through EBM, has come from God. Therefore, we must humbly recognize that the purpose of this knowledge is to draw us closer to God, not merely to use it for decision-making without regard for God's desire for us.

The primary reason for evidence-based medicine (EBM) is to point us towards God's 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, in whose 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.

Conclusion

Evidence-Based Medicine (EBM) is a practice firmly rooted in God's word. As 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 or proclaim it. Often, we ourselves neglect to proclaim this truth due to fear - we must 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 in allowing us to discover it, all with the purpose of drawing 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.

Epilogue

As with all good gifts that God gives us, they can and will be corrupted in the hands of humans. This reflection does not delve into the details, but just as the Bible, as a gift, can be corrupted, so too can evidence-based medicine (EBM). This is why we see corruption manifested in bribery of journal editors, statistical manipulation, and biased studies funded by medical companies. We are both victims and perpetrators of such corruption and thus are always in need of His grace.