“Insufficient” but still “necessary”? EBPM's dangerous leap of faith: Commentary on Porter and O’Halloran (2009)

Abstract

In the opening lines of ‘The postmodernist war on evidence-based practice’ (Porter andO’Halloran, 2009), the authors erect a false binary between health care practice ‘informed by research’ and ‘those who argue that there should be no restrictions on the sources of knowledge used by practitioners’. This, the authors submit, is the distinction between the evidence-based approach and the postmodern approach. But nothing could be further from the truth. First, according to this characterisation, the relatively narrow understanding of ‘‘research’’ promulgated by the evidence-based practice movement is set up as the only type of research that can count as research. This is empirically false and dangerously misguided. Second, the authors understand postmodern approaches as epistemologically vacuous and as ‘‘anything-goes’’. This view is also wrong. It is unsurprising, then, that the paper’s summary of our critical work on evidence-based practice movement (EBPM) is at times misguided, decontextualised. Fine; but let us focus instead on the epistemic stakes, the claims of the paper itself. The paper fails to provide a substantive reflection regarding the limits of EBPM in clinical practice. These limits are acknowledged by the authors, but are not met with solutions or alternatives that would address them. While what the authors contend is not incorrect, it does not contribute anything new to the ongoing debate about the hegemony of EBPM in clinical and research settings. For instance, it is not enough to claim that EBPM is