Over the last 20 years, the evidence-based medicine (EBM) movement has sought to develop standardised approaches to patient treatment by drawing on research results from randomised controlled trials (RCTs). The Cochrane Collaboration and its eponym, Archie Cochrane, have become symbols of this development, and Cochrane's book from 1972 is often referred to as the first sketch of what was to become EBM. In this article, we claim that this construction of EBM's historical roots is based on a selective reading of Cochrane's text. Through a close reading of this text, we show that the principal aim of modern EBM, namely to warrant clinical decisions based on evidence drawn from RCTs, is part of Cochrane's original project. He had more modest ambitions for what RCTs can accomplish, and, more importantly, he was more concerned with care and equality than are his followers in the EBM movement. We try to reconstruct some of Cochrane's lost legacy and to articulate some of the important silences in From these clues it might be possible, we argue, to remodel EBM in a broader, more pluralistic, more democratic and less authoritarian manner.
In a recent article, Gorik Ooms has drawn attention to the normative underpinnings of the politics of global health. We claim that Ooms is indirectly submitting to a liberal conception of politics by framing the politics of global health as a question of individual morality. Drawing on the theoretical works of Chantal Mouffe, we introduce a conflictual concept of the political as an alternative to Ooms' conception. Using controversies surrounding medical treatment of AIDS patients in developing countries as a case we underline the opportunity for political changes, through political articulation of an issue, and collective mobilization based on such an articulation. Keywords: Global Health, Liberal Politics, Chantal Mouffe, Conflict, AIDS, Antiretroviral (ARV) Treatment Copyright: © 2016 by Kerman University of Medical Sciences Citation: Askheim C, Heggen K, Engebretsen E. Politics and power in global health: the constituting role of conflicts: Comment on "Navigating between stealth advocacy and unconscious dogmatism: the challenge of researching the norms, politics and power of global health.
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Department of Physiotherapy. Her research interests include critical perspectives on medicine, healthcare and physiotherapy. Birgitte's doctoral research focused on the role of gender in illness narratives of chronic pain. Her present research project focuses on the first clinical encounter between patients and physiotherapists and relates to issues of knowledge production and translation, as well as how the patient is constituted in physiotherapy practice. She is a physiotherapist with 25 years of diverse clinical experiences and a specialist in (Norwegian) psychomotor physiotherapy. Alette Ottesen is a physiotherapist and specialist in (Norwegian) psychomotor physiotherapy, with her own practice and almost 40 years of experience from working as a clinician. She is an assistant in FYSIOPRIM, a research program at the University of Oslo which aims to improve research in primary healthcare and bridging the gap between research and clinical practice.Alette also works as a lecturer at OsloMet -Oslo Metropolitan University, teaching practical skill to students in professional development courses in the area of psychomotor physiotherapy.Alette's interests are related to issues concerning physiotherapy practice and questions about what physiotherapy is and could be.
Evidence‐based healthcare is the prevailing model for healthcare services. In Cochrane's seminal thinking, political context was included with the purpose of promoting healthcare equity. However, the subsequent evidence‐based healthcare models marginalized political context. In this paper, we argue that current models of evidence‐based healthcare fail to respond to emerging healthcare challenges. We claim that reintegration of political context is crucial to make healthcare sustainable. Global communities are anticipating ecological crises with immense repercussions for healthcare. This prospect illustrates that healthcare models failing to integrate political context also risk neglecting some of the most relevant healthcare issues of our time.
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