Evidence-Based Practice is all around us. Not only has medicine embraced its principles, but so have education, social welfare, criminal justice and, last but not least, management. With only slight exaggeration, Evidence-Based Practice can be said to be emblematic of the modern professional. This chapter addresses the implications of this trend toward Evidence-Based Practice, by taking a close look at its first introduction, in medicine. Given Evidence-Based Medicine's almost paradigmatic status, we then will cover the similarities and the differences between the two professional fields. In doing so, we will show that the hindrances that block the further development of Evidence-Based Management today are the same hindrances that blocked the development of Evidence-Based Medicine two decades ago.

Summary This article is looking at colonial governance with regard to leprosy, comparing two settings of the Dutch colonial empire: Suriname and the Dutch East Indies. Whereas segregation became formal policy in Suriname, leprosy sufferers were hardly ever segregated in the Dutch East Indies. We argue that the perceived needs to maintain a healthy labour force and to prevent contamination of white populations were the driving forces behind the difference in response to the disease. Wherever close contact between European planters and a non-European labour force existed together with conditions of forced servitude (either slavery or indentured labour), the Dutch response was to link leprosy to racial inferiority in order to legitimise compulsory segregation. This mainly happened in Suriname. We would like to suggest that forced labour, leprosy and compulsory segregation were connected through the ‘colonial gaze’, legitimising compulsory segregation of leprosy sufferers who had become useless to the plantation economy.

It has been stated many times: traditionally, medical history was written by, for and about doctors, telling the story of unilinear scientific progress. Positivism tended to look at the history of medicine as a process of linear progress from religion through metaphysics to science, in which mankind was liberated from superstition and irrationality. This view was confirmed by the Weberian notion of a "disenchantment" of the world: in the course of the last few centuries, the influence of magic and animism was seen as having declined. In the field of medical thinking and medical practice, man was thought to have freed himself from the chains of superstition. Gradually, he had learned to relate to the world in rational terms; in the event of illness, academic doctors were the logical engineers of his body. However, the times of the grand stories are over, in general as well as in medical history. With non-physicians moving into the field, there has been a growing awareness of the constructed nature of medicine.1 Medical knowledge has come to be seen as functioning within a specific cultural context from which it derives its meaning.2 Today, illness is no longer considered to be a universal, ontological unit. Instead, the meaning of illness-as well as the response to it-is thought to be determined by factors of a social, economic, political and religious nature.3The attraction of the old historical image lay in its simplicity. However, it is highly problematic to characterize developments in the field of health care in terms of a

Many nations, healthcare organizations and interest groups are addressing the question of how patients can best be involved in designing and executing patient safety policy. Looking back at how patient engagement has developed in healthcare, we can draw lessons on how to engage patients in patient safety.