Evidence-based medicine: ambivalent reading and the clinical recontextualization of science

被引:35
作者
Mykhalovskiy, E [1 ]
机构
[1] Dalhousie Univ, Fac Med, Dept Community Hlth & Epidemiol, Halifax, NS B3H 3J5, Canada
来源
HEALTH | 2003年 / 7卷 / 03期
关键词
clinical practice; evidence-based medicine; governmentality; institutional ethnography; physicians; reading; texts;
D O I
10.1177/1363459303007003005
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
This article contributes to the investigation of evidence-based medicine (EBM) as text-mediated relations of governance. Social critiques of EBM typically rely on a negative conception of power, such that EBM is considered to contain or limit the scope of medical practice. This article, by contrast, explores EBM as a productive relation, one that governs through medicine's 'freedom' and opens up spaces of intervention. The article draws on an institutional ethnographic study of a research transfer initiative called informed - an evidence-based newsletter for family physicians. My investigation of the work practices of making informed underscores how texts are fundamental to the social organization of EBM. Through the example of informed, I locate reading as a central object of governance within EBM. I emphasize how the problematization of physicians as indifferent readers is linked with an effort to intervene in medical work through a new kind of text that clinically recontextualizes biomedical science.
引用
收藏
页码:331 / 352
页数:22
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