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Evidence-Based Medicine: Ambivalent Reading and the Clinical Recontextualization of Science

Eric Mykhalovskiy

Dalhousie University, Canada eric.mykhalovskiy{at}dal.ca

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.

Key Words: clinical practice • evidence-based medicine • governmentality • institutional ethnography • physicians • reading • texts

Health:, Vol. 7, No. 3, 331-352 (2003)
DOI: 10.1177/1363459303007003005
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