Resisting complexity; evidence based knowledge and the neglect of practice

Mette Irmgard Snertingdal (SIRUS)Cecilie Basberg Neumann (AFI)

Evidence based medicine is the conscientious, explicit, and

judicious use of current best

evidence in making decisions about the care of individual

patients (Sackett 1996 p.

71)

“Drug Policy and the Public Good are collaboratively written by an international group of career scientist to provide an analytical basis on which to build relevant global drug policies and to inform policy makers who have direct responsibility for public health and social welfare”

(Babor et.al 2010)

“Science takes stock”

Thought figure:

Practitioners

Evaluation data

Literature review

Policymakers

Knowledge hierarchy

Experimental studies

Randomized control studies

Literature review

What does the concept of evidence refer to?

That the knowledge produced by social scientists are:

(A)Unambiguous?

(B) Irrefutable?

(C)Speak for themselves?

What is the relationship between social injustice, drug use and different drug policies intended and unintended consequences?

What is the connection between the concept of harm, risk, stigmatization and marginalization?

How should the practitioners relate to the evidence produced by science?

Evidence based practice can:

Reduce the practitioners autonomy and increase their responsibility

Lead to a “cookbook” approach where the profession specific assessments are made redundant

Be used politically to cut down on foundlings to health and social care

Research UtilizationResearch seldom change the

direction of a given policy (Weiss 1977, 1980, 1999)

Policymakers will use the evidence which is best adjusted to the political logic and rhetoric ( Black 2001, Stevens 2007)

Evidence is used if it supports the consensus and is used selectively if there is a lack of consensus (Weiss 1977, Black 2001, Stevens 2007)

What level of policymaking should be evidence based?

A) Practice policies (use

of recourses by practitioners)

B) Service policies (recourses allocation, pattern of services)

C) Governance policies (organizational and financial structures)

What level of drug policy should be evidence based?

“Thank you very much for your attention!”