Fascists and Bush and All

Okay, time to stop messing around. I’ve been putting it off, but it can’t be shirked any longer. I have to make fun of the whole article, all of it, not just selected highlights. I have to be thorough.

…this fascism of the masses, as was practised by Hitler
and Mussolini, has today been replaced by a system of
microfascisms – polymorphous intolerances that are
revealed in more subtle ways. Consequently, although the
majority of the current manifestations of fascism are less
brutal, they are nevertheless more pernicious.

Less brutal (there’s the not killing millions of people by shooting or overworking or gassing them for instance) but more pernicious? Really? More pernicious in what way? They don’t say. They just get to the important part:

Therefore, we will use this term
as defined by Deleuze and Guattari, and now used by a
number of contemporary authors.

Ah. It’s used by a number of contemporary authors – so it’s okay then. There’s bravery, there’s rebellion, there’s independence of mind. But then what about ‘Because ‘regimes of truth’ such as the evidence-based movement
currently enjoy a privileged status, scholars have not only a scientific duty, but also an
ethical obligation to deconstruct these regimes of power’? What about privileged status, what about regimes of power? If Deleuze and Guattari and ‘a
number of contemporary authors’ have the power and privileged status to make it okay to use the word ‘fascism’ to refer to the evidence-based movement
in the health sciences, then…isn’t that a regime of power based on privileged status? Why is one kind okay while the other isn’t? Because – because our authors aren’t really thinking? Is that it? They’re just performing a ritual, that’s meant to look like (high-status) thinking, but isn’t? Could be.

There’s a longish sane part after that, where they at least could be talking sense. Maybe it’s true that the EBHS approach is too narrow and/or rigid; I don’t know. But then things go funny again.

We believe that health sciences
ought to promote pluralism – the acceptance of multiple
points of view. However, EBHS does not allow pluralism,
unless that pluralism is engineered by the Cochrane
hierarchy itself. Such a hegemony makes inevitable the
further ‘segmentation’ of knowledge (i.e. disallowing multiple
epistemologies), and further marginalise many forms
of knowing/knowledge.

Uh oh. Pluralism and the acceptance of multiple
points of view and multiple
epistemologies and many forms
of knowing/knowledge – that all sounds much too much like Sandra Harding on a bad day. It could (just) mean something sane but it could also mean ‘anything goes’.

As a response to this, a vigilant resistance must arise from
within the health disciplines themselves, and one way of
deploying such resistance is by using a tool called ‘deconstruction’.
Drawing on the work of the late French philosopher,
Jacques Derrida, deconstruction is notoriously difficult to
define because it is a practice, and not a fixed concept
based on abstract ‘facts’ or ‘evidence’.

Okay. Let’s not use it then. Let’s use something else, that’s not so terribly hard to define, because it has this problem with facts and evidence.

But no. No such luck.

a deconstructive vein, we must ask not only, ‘What constitutes
evidence?’ but also, what is the ‘regime of truth’ (Kuhn
would call this a ‘paradigm’ and Foucault an ‘épistèmé’) that
dictates when or how one piece of evidence shall count as
evidence, while another is denigrated or excluded altogether?

What indeed. What regime of truth is it that dictates that. It’s probably dressed up in a Nazi uniform and wearing those boots. Bastard.

We believe that EBM, which saturates health sciences discourses,
constitutes an ossified language that maps the landscape
of the professional disciplines as a whole. Accordingly,
we believe that a postmodernist critique of this prevailing
mode of thinking is indispensable.

See there’s your problem right there – it’s that ‘accordingly.’ That accordingly doesn’t belong there. The second sentence doesn’t follow from the first, so that accordingly has shoved its way in (or interpellated itself do I mean?) from some other pair of sentences one of which does follow from the other. In other words, that first sentence could be quite true (that’s some more of the sane part) without that second one following from it at all. One, maybe EBM is ossified, but two, why would a postmodernist critique be indispensable? Why not a nonpostmodern critique instead?

Those who are wedded
to the idea of ‘evidence’ in the health sciences maintain
what is essentially a Newtonian, mechanistic world view:
they tend to believe that reality is objective, which is to say
that it exists, ‘out there’, absolutely independent of the
human observer, and of the observer’s intentions and observations.
They fondly point to ‘facts’, while they are forced
to dismiss ‘values’ as somehow unscientific.

I guess that’s why the postmodern critique is indispensable: because it says stuff like that, and it knows where the box of scare-quotes is kept.

Along with Deleuze and Guattari, we understand such
fascist logic as a desire to order, hierarchise, control, repress,
direct and impose limits…In light of our argument, fascism is not
too strong a word because the exclusion of knowledge
ensembles relies on a process that is saturated by ideology and intolerance regarding other ways of knowing.

And it resembles George Bush, too. Why not, after all?

The all-embracing economy of such ideology lends the
Cochrane Group’s disciples a profound sense of entitlement,
what they take as a universal right to control the scientific
agenda. By a so-called scientific consensus, this ‘regime of
truth’ ostracises those with ‘deviant’ forms of knowledge,
labelling them as rebels and rejecting their work as scientifically
unsound. This reminds us of a famous statement by
President George W Bush in light of the September 11
events: ‘Either you are with us, or you are with the terrorists’.
In the context of the EBM, this absolutely polarising world
view resonates vividly: embrace the EBHS or else be condemned
as recklessly non-scientific.

Bastards. Fascist Bush-like ostracising bastards.

Okay that’s better. I don’t like to leave these little jobs half-done.

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