Moral entrepreneurship, the power‐knowledge nexus, and the Cochrane 'crisis'
Autor: | Trisha Greenhalgh, Sara Shaw, Mustafa Özbilgin, Barbara Prainsack |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Entrepreneurship
Original Paper evidence‐based medicine 030503 health policy & services Health Policy Corporate governance Public Health Environmental and Occupational Health systematic reviews Evidence-based medicine 16. Peace & justice Original Papers Rigour philosophy of medicine 03 medical and health sciences Good governance Systematic review Reflexivity Accountability Sociology Positive economics 0305 other medical science |
Zdroj: | Journal of Evaluation in Clinical Practice |
ISSN: | 1365-2753 1356-1294 |
Popis: | Background In 2018, a so‐called crisis developed in the international network of systematic reviewers known as Cochrane. It was widely depicted in terms of two competing narratives—“bad behaviour” by one member of Cochrane's Governing Board and scientific and moral decline within Cochrane. Objective Our goal was to distil insights on the structural issues underpinning the crisis, without taking a definitive position on the accuracy of either narrative. Approach and dataset In this paper, we draw on (among other theories) Becker's notion of moral entrepreneurship and Foucault's conceptualisation of power to analyse the claims and counterclaims made by different parties. Our dataset consisted of publicly available materials (blogs, journal articles, newspaper articles) to end 2018, notably those relating to the expulsion of one Governing Board member. Main findings Both narratives include strong moral claims about the science of systematic review and the governance of scientific organizations. The expelled individual and his supporters defined good systematic reviews in terms of a particular kind of methodological rigour and elimination of bias, and good governance largely in terms of measures to achieve independence from industry influence. Most of Cochrane's Governing Board and their sympathizers evaluated systematic reviews according to a broader range of criteria, incorporating factors such as attention to relationships among reviewers and reflexivity and dialogue around scientific and other judgements. They viewed governance partly in terms of accountability to an external advisory group. Power‐knowledge alignments in Cochrane have emerged from, and contributed to, a particular system of meaning which is now undergoing evolution and challenge. Conclusion Polarizing Cochrane's “crisis” into two narratives, only one of which is true, is less fruitful than viewing it in terms of a duality consisting of tensions between the two positions, each of which has some validity. Having framed the conflict as primarily philosophical and political rather than methodological and procedural, we suggest how Cochrane and its supporters and critics might harness their tensions productively. |
Databáze: | OpenAIRE |
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