sufficient evidence that they can be expected to produce their intended effects (Eddy, 1996). The Australian Health Minister, Dr Michael Wooldridge, adopted a very similar position stating “[we will] pay only for those operations, drugs and treatments that, according to available evidence, are proved to work” (Downey, 1997). While we believe that evidence for psychoanalytic interventions are important to derive, we are sceptical about the pressures brought on psychoanalytic clinicians as it seems to us unlikely that even in the face of overwhelming evidence as to the benefits of this relatively expensive treatment, the resources would be available to provide psychoanalysis for a significant proportion of those who require it. We shall consider the specific issue of cost effectiveness separately. In this context it is important to review the philosophical basis of the search for evidence for psychoanalysis in order to gain perspective on the entire enterprise of outcomes research. Perron’s (2001) critique has covered some of these issues from a more general epistemological standpoint; here some additional conceptual and practical concerns will be briefly explored. 74*5$2$%4*/15!/$#/&(#2! Evidence based medicine represents a practical example of “consequentionalism”. Consequentionalism refers to the proposition that the worth of an action may be assessed by the measurement of its consequences. There are at least three problems with the consequentionalist argument, all of which apply to psychoanalytic outcome research: (a) the difficulty in measuring outcomes, (b) the ownership of outcomes (whose interest should be considered?), (c) consequentionalism may lead to unethical conclusions. We shall take these in turn. /#$<)6)1#$72
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