{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T02:36:40Z","timestamp":1761187000565,"version":"build-2065373602"},"reference-count":43,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Philosophies"],"abstract":"<jats:p>Evidence-based medicine (EBM) supplies the best available data, yet clinicians still face low-value care, surrogate-driven reversals, and pseudoscientific claims. We propose Semi-Imperative Evidentialism (SIE), a normative framework that links evidential warrant to proportionate professional duties while preserving patient autonomy. Using a targeted narrative review in philosophy of science, bioethics, and clinical epidemiology, we distilled six binary attributes to classify activities as Science, Pseudoscience, or Non-science. Scientific items enter a two-tier ladder\u2014Tier 1 (established clinical evidence) or Tier 2 (emerging or preclinical evidence)\u2014with status re-scored as randomized trials, living meta-analyses, and post-marketing safety signals accrue. SIE maps tiers to action: Tier 1 should be offered or strongly recommended, with reasons documented if declined; Tier 2 should be discussed with explicit consent, preferably within trials or registries; Pseudoscience should be refused or discontinued with corrective education; Non-science may be acknowledged as contextual support when safe and non-substitutive. Worked examples\u2014antiarrhythmic suppression post\u2013myocardial infarction (CAST) and \u201ccomplementary cancer cures\u201d\u2014illustrate earlier and more transparent course-correction. SIE provides a fallibilist bridge from evidence to duty, constraining discretion without eroding autonomy; prospective audits and cluster trials should test its impact on prescribing and consent.<\/jats:p>","DOI":"10.3390\/philosophies10060115","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T01:14:02Z","timestamp":1761182042000},"page":"115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating Morality and Science: Semi-Imperative Evidentialism Paradigm for an Ethical Medical Practice"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3835-6067","authenticated-orcid":false,"given":"Jos\u00e9 Nunes","family":"de Alencar","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"},{"name":"Instituto Dante Pazzanese de Cardiologia, Avenida Dr. Dante Pazzanese No. 500, Vila Mariana, S\u00e3o Paulo 04012-091, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-7895","authenticated-orcid":false,"given":"Francisca","family":"Rego","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1377-9899","authenticated-orcid":false,"given":"Rui","family":"Nunes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/S0140-6736(95)91850-7","article-title":"Evidence-based medicine","volume":"346","author":"Sackett","year":"1995","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.312.7023.71","article-title":"Evidence based medicine: What it is and what it isn\u2019t","volume":"312","author":"Sackett","year":"1996","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/1049732313519707","article-title":"A forerunner of qualitative health research: Risueno\u2019s report against the use of statistics","volume":"24","author":"Torralbo","year":"2014","journal-title":"Qual. 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