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On the constitution and status of ‘evidence' in the health sciences

Faculty of Arts and School of Graduate Studies, Ryerson University, Toronto, Ontario, Canada

Dave Holmes

Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada

Geneviève Rail

Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada

Abstract

Drawing on the philosophy of Michel Foucault and Gilles Deleuze, this paper interrogates the constitution of ‘evidence' that defines the evidence-based movement in the health sciences. What are the current social and political conditions under which scientific knowledge appears to be ‘true'? Foucault describes these conditions as state ‘science', a regime that privileges economic modes of governance and efficiency. Today, the Cochrane taxonomy and research database is increasingly endorsed by government and public health policy makers. Although this ‘evidence-based' paradigm ostensibly promotes the noble ideal of ‘true knowledge' free from political bias, in reality, this apparent neutrality is dangerous because it masks the methods by which power silently operates to inscribe rigid norms and to ensure political dominance. Through the practice of critique, this paper begins to expose and to politicise the workings of this power, ultimately suggesting that scholars are in a privileged position to oppose such regimes and foremost have the duty to politicise what hides behind the distortion and misrepresentation of ‘evidence'.

Key Words: Cochrane • criticism • Deleuze • ethics • evidence-based nursing • evidence-based practice • Foucault

Journal of Research in Nursing, Vol. 13, No. 4, 272-280 (2008)
DOI: 10.1177/1744987108093529


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