CONCEPTIONS OF TRUTH IN EVIDENCE-BASED PRACTICE

Abstract

Evidence-based practice, EBP, is the purposeful search for current best evidence in the evaluation and decision making process as a basis for the implementation of practices and policy. Rarely however is the foundation of what underlying epistemological value EBP strives for in this pursuit of ‘best available evidence’ either analyzed or conceptualized. One possible contender is truth. Truth is often assumed as the foundational aim of science and epistemology and thus extrapolating truth to EBP, as an extension of the scientific project, seems poignant. This thesis analyses truth in relation to EBP through the ontological and epistemological foundations of truth as exemplified through common concepts of truth, views of truth in science and philosophy of science and ultimately through the point of view of contemporary notions of truth in EBP. By contrasting three contemporary depictions of truth within EBP to traditional truth concepts, such as correspondence, coherence, semantic, deflationist and pragmatic theories of truth, a depiction of the fundamentally different perspectives of truth, and underlying ontology, permeating EBP emerges. The aim is to evaluate truth conceptions within EBP and establish their foundations as truth explicators. The discussion centers the foundation of these truth conceptions - if they relate truth to some foundational notion based in truth theory or if truth is understood as something constructed or defined based on pragmatics, context or purpose. One suggestion drawn from the analysis is that a semantic as well as conceptual conflation exists whereby truth concepts within EBP do not explicate truth per se, as per truth theory, neither in the ubiquitous, ordinary language sense, nor in the conception drawn from the scientific sphere, but rather truth as perspectivalist. Truth is thus understood through context and pragmatics, rather than through objective being as seen in a realist ontology and manifested in the reflection of a truth-maker. The worry is that truth conceptions within EBP inherently allows for such realism which may have repercussions on the implementation of policy and the general understanding of science.