Deconstructing the evidence-based discourse in health sciences: truth, power and fascism.

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.

[1]  K. Walker Why evidence-based practice now?: a polemic. , 2003, Nursing inquiry.

[2]  M. Traynor The oil crisis, risk and evidence-based practice. , 2002, Nursing inquiry.

[3]  D. Holmes,et al.  Rhizomatic thought in nursing: an alternative path for the development of the discipline. , 2004, Nursing philosophy : an international journal for healthcare professionals.

[4]  S. Winch,et al.  Governing nursing conduct: the rise of evidence-based practice. , 2002, Nursing inquiry.

[5]  M. Coté,et al.  'Society Must Be Defended': Lectures at the College de France , 2004 .

[6]  Martin Jay,et al.  Downcast Eyes: The Denigration of Vision in Twentieth-Century French Thought , 1993 .

[7]  Response to Kim Walker: Why evidence-based practice now?: a polemic. , 2003, Nursing inquiry.

[8]  J. Derrida,et al.  Speech and Phenomena: And Other Essays on Husserl's Theory of Signs , 1967 .

[9]  S. Satya‐Murti Evidence-based Medicine: How to Practice and Teach EBM , 1997 .

[10]  G M Mathwig,et al.  Nursing science. , 1969, Image.

[11]  J. Krantz,et al.  The birth of the clinic. An archaeology of medical perception , 1975, Medical History.

[12]  D. Holmes,et al.  Evidence, virulence, and the disappearance of nursing knowledge: A critique of the evidence-based dogma. , 2006, Worldviews on evidence-based nursing.

[13]  D. Spence Anti-Oedipus: Capitalism and schizophrenia. , 1978 .

[14]  David Macey,et al.  Society Must Be Defended: Lectures at the Collège de France, 1975-76 , 2020 .

[15]  A. Robertson Embodying risk, embodying political rationality: Women's accounts of risks for breast cancer , 2000 .

[16]  Nikolas Rose,et al.  The Politics of Life Itself , 2001, The New Social Theory Reader.

[17]  M. Foucault,et al.  The History of Sexuality, Volume 1: An Introduction , 1990 .

[18]  K. Walker Why evidence‐based practice now?: a polemic1 , 2003 .

[19]  B. Stone,et al.  Foucault, Michel . Abnormal: Lectures at the College de France,1974-1975 , New York:Picador, 2003; "Society Must Be Defended:"Lectures at the College de France, 1975-1976 . New York: Picador, 2003 , 2004 .

[20]  F. Guattari,et al.  A Thousand Plateaus: Capitalism and Schizophrenia , 1980 .

[21]  M. Foucault,et al.  Power/Knowledge: Selected Interviews and Other Writings 1972-1977 , 1980 .

[22]  B. Massumi,et al.  The postmodern condition : a report on knowledge , 1979 .

[23]  E. Voegelin The Origins of Totalitarianism , 2020, On Violence.

[24]  A. Robertson Biotechnology, Political Rationality and Discourses on Health Risk , 2001 .

[25]  C. Bonell Evidence-based nursing: a stereotyped view of quantitative and experimental research could work against professional autonomy and authority. , 1999, Journal of advanced nursing.

[26]  Elizabeth Ann Manhart Barrett,et al.  What is Nursing Science? , 2002, Nursing science quarterly.