Yes. And moreover, how could you hope to empower the powerless by offering
them untested or ineffective interventions? So what would be the author's
alternative to evidence- based medicine, or for that matter, evidence- based
social work or education?
These kinds of weak arguments are frequently made some quarters of social
science. [I can find you other examples......if you are sure really want to
read them!] This talk of 'unequal power' misses the point that EBHC etc tries
make information accessible as widely as possible (eg cochrane consumer
network), has a basic ethic of openness to scrutiny of information, and has
contributed to some excellent partnerships with consumers, eg in maternity care.
Dr Frances Gardner
University Lecturer in Evidence-Based Social Work
Department of Social Policy & Social Work, Oxford University
32 Wellington Square, Oxford OX1 2ER, UK
tel:44-1865-270334 email: [log in to unmask]
In message <[log in to unmask]> Eric Harvey
<[log in to unmask]> writes:
> The author presents a very weak argument, filled with many unsupported
assertions. In particular, Flic clearly misrepresents EBM practice by
asserting that EBM ignores the role of social context. I believe that
consideration of social context is specified in the following definition of EBM
practice: The practice of evidence-based medicine requires integration of
individual clinical expertise and patient preferences with the best available
external clinical evidence from systematic reviews. (Guyatt G, Rennie D., eds.
Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical
Practice. Chicago, IL: AMA Press; 2002:674)
>
> I'm no expert in critically appraising papers written specifically for the
social sciences, but I got a strong sense of self-serving and victimized
undertones from the paper.
>
> I'd welcome reactions from others. How off-target am I?
>
> Best regards,
>
> Eric Harvey, PharmD, MBA, BCPS
>
> ----- Original Message -----
> From: Netuveli, Gopal
> To: [log in to unmask]
> Sent: Friday, July 16, 2004 9:53 AM
> Subject: Medicalization and EBM
>
>
> Dear all,
>
> Some of you might be interested in this article in which EBM is used as an
example of medicalization. I will appreciate if any one has other examples.
>
> Filc D. The medical text: between biomedicine and hegemony.Social Science &
Medicine 59 (2004) 1275–1285
> Abstract
> The unequal distribution of power in contemporarysocietyis re.ected and
reproduced in medical ideology. The present article analyses some articles from
Israeli medical journals in order to show the ways in which biomedicine—the
dominant medical ideology—is reinforced through hegemonic discourse. The
central ways by which this is achieved are medicalization—which includes the
desocialization of disease and the explanation of social phenomena in medical
terms—and the af.rmation bythe Israeli medical literature of national,
ethnic, class and gender relationships of domination. Analysis of the Israeli
example provides useful insights about biomedicine’s desocializing role, as
the disregard for the social dimension of disease is particularlytelling in a
societycharacterized by several cleavages which determine a clearlyunequal
distribution of power and resources.
>
> G. Netuveli
> Department of Primary Care and Social Medicine
> Imperial College London
> Reynolds Building, Charing Cross Campus
> St Dunstan's Road, London W6 8RP
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