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Reconstituting populations through evidence-based medicine: an ethnographic account of recommending procedures for diagnosing type 2 diabetes in clinical practice guidelines

Melanie Rock

University of Calgary, Canada, mrock{at}ucalgary.ca

This ethnographic investigation responds to calls for more social science research on - versus for or against - evidence-based medicine (EBM). It centers on the recommendations endorsed, in a set of clinical practice guidelines, by Canadian specialists in the late 1990s for diagnosing diabetes. Empirically, the article mainly relies on public presentations and discussion at the Canadian Diabetes Association Professional Conferences (1997-2001), supplemented by findings from documentary sources, direct observation, participant-observation and interviews. It confirms the importance of clinical reason and clinical epidemiology as preconditions for EBM, the textually mediated character of EBM and patients’ bodies as sites for producing knowledge crucial to EBM. Most significantly, it also demonstrates the importance of non-patients’ bodies as sites for producing knowledge that is crucial to EBM and its politics. EBM politics encompass the discursive, socio-technical and visceral reconstitution of populations.

Key Words: Canada • clinical practice guidelines • diabetes • ethnography • evidence-based medicine

Health:, Vol. 9, No. 2, 241-266 (2005)
DOI: 10.1177/1363459305050587
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