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Keywords:

  • best-practices;
  • critique;
  • ethics;
  • evidence-based medicine (EBM);
  • Foucault;
  • power

Abstract

No exit? Have we arrived at an impasse in the health sciences? Has the regime of ‘evidence’, coupled with corporate models of accountability and ‘best-practices’, led to an inexorable decline in innovation, scholarship, and actual health care? Would it be fair to speak of a ‘methodological fundamentalism’ from which there is no escape? In this article, we make an argument about intellectual integrity and good faith. We take this risk knowing full well that we do so in a hostile political climate in the health sciences, positioning ourselves against those who quietly but assiduously control the very terms by which the public faithfully understands ‘integrity’ and ‘truth’. In doing so, we offer an honest critique of these definitions and of the systemic power that is reproduced and guarded by the gatekeepers of ‘Good Science’.