Below you can read a short excerpt from my new book co-authored with Mona Baker. Introduction and blurbs will be available soon!
“The COVID-19 crisis has transformed the highly specialized issue of what constitutes reliable medical evidence into a topic of public concern. Newspapers and social media abound with discussions about whether the evidence for wearing masks is weak or strong, or whether mass public health measures such as lockdowns or school closures are backed by sufficient evidence. At the same time, a global initiative for gathering evidence to support the development of new, more effective vaccines and drugs continues in laboratories and clinics that are far removed from these sites of public debate and from the immediate pressure of delivering healthcare in emergency situations. Underpinning all these different discussions about and approaches to evidence is a shared assumption: that evidence is singular and that it can be ranked on a singular scale as present or absent, strong or weak, from a purely rational, value-free perspective. This book interrogates the assumption that evidence means the same thing to different constituencies and in different contexts by outlining a more nuanced and socially responsive approach to medical expertise that incorporates scientific and lay processes of making sense of the world and deciding how to act in it. In so doing, it hopes to provide a point of orientation for clinicians working at the coalface, whose experience is sometimes at odds with the type of rationality that underpins evidence-based medicine (EBM) and that guides researchers conducting randomized controlled trials. The argument elaborated also has implications for policymakers in the healthcare system, who have to navigate similar pressures and contradictions between scientific and lay rationality to produce meaningful guidelines in the midst of a runaway pandemic.
While using COVID-19 as an exemplary case study, this book takes as its point of departure the premise that the controversies surrounding the nature of evidence were also present in earlier epidemics such as SARS and Ebola, and that they will continue to plague our responses to future pandemics unless we learn to address them more effectively. Pandemics in general, and COVID-19 in particular, are emblematic sites for exploring and challenging concepts of evidence because they clearly transform such concepts into a topic of public concern and demonstrate the relevance and urgency of engaging with the processes by which they come to be understood and assessed differently by various constituencies.”
Engebretsen, Eivind and Baker, Mona (2022, forthcoming). Rethinking Evidence in the Time of Pandemics: Scientific vs Narrative Rationality and Medical Knowledge Practices, Cambridge University Press.