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

Authors

  • Dave Holmes RN PhD,

    Corresponding author
    1. Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, and
      Associate Professor Dave Holmes, Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON, KIH OM5, Canada. Email: dholmes@uottawa.ca
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  • Stuart J Murray PhD,

    1. Department of English, Ryerson University Toronto, Ontario, Canada
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  • Amélie Perron RN PhD(cand),

    1. Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, and
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  • Geneviève Rail PhD

    1. Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, and
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Associate Professor Dave Holmes, Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON, KIH OM5, Canada. Email: dholmes@uottawa.ca

Abstract

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.

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