This paper systematically examines the differences between evidence-based medicine and narrative medicine across three dimensions: metaphysics, methodology, and ethics. Evidence-based medicine, rooted in reductionism and positivism, emphasizes the objectivity and universal laws of disease, relying on a hierarchical evidence system to promote standardized management. In contrast, narrative medicine founded on phenomenology, hermeneutics, and constructivism, focuses on the subjective experience an...更多
This paper systematically examines the differences between evidence-based medicine and narrative medicine across three dimensions: metaphysics, methodology, and ethics. Evidence-based medicine, rooted in reductionism and positivism, emphasizes the objectivity and universal laws of disease, relying on a hierarchical evidence system to promote standardized management. In contrast, narrative medicine founded on phenomenology, hermeneutics, and constructivism, focuses on the subjective experience and meaning-making of illness, advocating narrative understanding and relational governance. The two reflect inherent tensions between scientism and humanism, universality and particularity, objectivity and intersubjectivity. Based on a critical examination of their theoretical limitations and practical challenges, this paper demonstrates their deep complementarity and unity at the philosophical level，and the philosophical foundation of the integration of the them. Ultimately, an integrated paradigm of 'evidence-based narrative medicine' is proposed, advocating for the fusion of scientific evidence and narrative knowledge in clinical practice, education, and governance, to construct a patient-centered holistic medicine.收起
