The Making of a Medical Iconoclast

About Professor Murray Enkin

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After graduation from medical school at the University of Toronto in 1947, and interning for two years in Vancouver, Murray Enkin practised as a family doctor in rural Saskatchewan before undertaking specialist training in obstetrics and gynaecology at Long Island College Hospital, Brooklyn, USA.

He commenced his specialty practice in Hamilton, Ontario, and became the departmental chief of Obstetrics and Gynaecology at St. Joseph’s Hospital. As a speaker and an advocate for the International Childbirth Education Association, in Canada he lead moves to include husbands and partners in childbirth, and successfully challenged many unnecessary interventions. He also criticized many common interventions in obstetrical care for which no evidence of benefit existed.

Dr. Enkin was appointed to the faculty of the new McMaster University Medical School shortly after it was opened. Murray made a major contribution to both the development and critical evaluation of evidence-based medicine through his work and collaborations at McMaster and then at Oxford University. In the 1980s he worked with (now Sir) Iain Chalmers in developing the first register and regularly updated database in the world of controlled trials in an entire specialty in health care—that of perinatal medicine.

Their further collaborative work, along with Dr Marc Keirse and others at the National Perinatal Epidemiology Unit in Oxford UK, produced the landmark two volume Effective Care in Pregnancy and Childbirth. It was accompanied by a paperback summary, Guide to Effective Care in Pregnancy and Childbirth, designed to make the conclusions available in an affordable, portable form for primary care practitioners and childbearing women.

These projects provided the foundation and the model for the influential Cochrane Collaboration which supports the use of randomized controlled trials as the international basis of evidence-based health care. Through his support for a pilot project of nurse-midwifery in Hamilton at St.Joseph's hospital and for midwifery regulation Murray became an important contributor to the emergence of professional midwifery in Canada. In 1999 his contributions not only as a clinician, educator and researcher, but also as a humanist were acknowledged by McMaster University through establishment of the Murray and Eleanor Lecturship on Humanitarianism in Health Care. He was awarded the Order of Canada in 2013.

In later years, Professor Enkin widened his aread of interest to population health and the implications of philosophy of science for health research. He became senior consultant to the Program in eHealth Innovation at the University of Toronto Health Network, and Professor Emeritus in the departments of Clinical Epidemiology and Biostastitics, and Obstetrics and Gynaecology, McMaster University. As he became more aware and concerned about the limitations, as the strengths, of evidence-based medicine as currently conceived, he began to explore other avenues for the creation, use, exchange and uptake of health knowledge.  

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