Jenny Advocat wrote on Sun, 18 Jul 2004 03:44:14 +0000

In response to the critique of Filc’s article in Social Science and Medicine, I have a couple of comments:

Firstly, the article is a critique of specific articles in a specific journal, which are analysed to illustrate the way(s) in which the social dimensions of health/illness are often neglected in biomedicine.  It is not a condemnation of all things biomedical (see bottom of page 1276, particularly the inclusion of Lupton).  Secondly, the article is one of a long tradition within the social sciences to critique current practice within biomedicine.  Wouldn’t it be possible, more useful, as well as more interesting, to consider the ways in which a critique like this may intersect with the philosophy of EBM—instead of so quickly attempting to delegitimise it? (Really, this article reflects rigorous social scientific work, and in my opinion it is simply wrong, as well as not useful, to compare it to the Sokal hoax; taking the critique down the path of pop-‘post-modernism’ seems just silly, and unfair, to me). The article may (or may not) leave some things to be desired by proponents of EBM, but I would argue that in order for any of us (social scientists and EBM proponents) to succeed in practicing interdisciplinarity we should use articles such as this one to open up discussions around the methods that could be used to work towards common goals such as improving health care practices etc….  If there is (and I think there probably is) critical reflection within EBM, this should be articulated in a critique of this article.  At present, it is not well articulated and in characteristic defensiveness the response has, instead, been to simply bring up the fact of consumer input…which does not speak to the point made in this article: simply that biomedical research and practice does not often include a consideration of the social dimension of people’s lives.  More interestingly, I think, this article and the response to it, point to starkly different epistemologies guiding EBM and the social sciences. Our job, then, is to discover how these different ways of thinking may be brought together to achieve common goals.