How To Make National Health Care Cheaper

Four Canadians, three with PhDs and one a PhD candidate affiliated with English and Nursing departments at two Canadian Universities, have published an article denouncing evidence-based health science as a fascist plot:

Background 

Drawing on the work of the late French philosophers Deleuze and Guattari, the objective of this paper is to demonstrate that the evidence-based movement in the health sciences is outrageously exclusionary and dangerously normative with regards to scientific knowledge. As such, we assert that the evidence-based movement in health sciences constitutes a good example of microfascism at play in the contemporary scientific arena.

Objective 

The philosophical work of Deleuze and Guattari proves to be useful in showing how health sciences are colonised (territorialised) by an all-encompassing scientific research paradigm - that of post-positivism - but also and foremost in showing the process by which a dominant ideology comes to exclude alternative forms of knowledge, therefore acting as a fascist structure.

Conclusion 

The Cochrane Group, among others, has created a hierarchy that has been endorsed by many academic institutions, and that serves to (re)produce the exclusion of certain forms of research. Because 'regimes of truth' such as the evidence-based movement currently enjoy a privileged status, scholars have not only a scientific duty, but also an ethical obligation to deconstruct these regimes of power.

The entire article can be read here.

It is tempting to end with this paragraph, from their conclusion:

The evidence-based enterprise invented by the Cochrane Group has captivated our thinking for too long, creating for itself an enchanting image that reaches out to researchers
and scholars. However, in the name of efficiency, effectiveness and convenience, it simplistically supplants all heterogeneous thinking with a singular and totalising ideology. The all-embracing economy of such ideology lends the Cochrane Group’s disciples a profound sense of entitlement, what they take as a universal right to control the scientific agenda. By a so-called scientific consensus, this ‘regime of truth’ ostracises those with 'deviant’ forms of knowledge, labelling them as rebels and rejecting their work as scientifically unsound. This reminds us of a famous statement by President George W Bush in light of the September 11 events: ‘Either you are with us, or you are with the terrorists’. In the context of the EBM, this absolutely polarising world view resonates vividly: embrace the EBHS or else be condemned as recklessly non-scientific.

Note the artistry of the reference to the 9/11 "events." (We certainly can't call them attacks.) This puts it about right: you can be with the US, GWB and the West, or you can be with our enemies. No evidence-based micro-facism there.

But I'm not going to end there, because the real fun is the Acknowledgment: "Dave Holmes and Amélie Perron would like to thank the Canadian Institutes of Health Research – Institute of Gender and Health for funding. Stuart Murray and Geneviève Rail would like to thank the Social Science and Humanities Research Council of Canada for funding." If I depended upon the Canadian state for my healthcare, I might be nervous about their funding an argument against evidence-based heath science. Then again, the native shamans might not have as long a waiting list.

UPDATE: Mini-fascism spreads: Medical advice: Know your shaman (Reuters, 8/16/06)

Peru's government warned people to be wary of fake medicine men offering cure-all miracle herb potions Tuesday, after a bogus brew killed a man hoping to shake off a spell of bad luck.