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By Susan White

The matter of scientific judgement has been lowered to the straightforward query: what works? even if, prior to clinicians can start to take into consideration what works, they need to first handle extra basic questions corresponding to: what is wrong? or what kind of challenge is that this? The advanced ways that execs negotiate the method of case formula stay extensively under-explored within the latest literature. This paintings examines this ignored zone. Drawing at the authors' personal targeted ethnographic and discourse analytic experiences and on advancements in social technological know-how, the publication goals to reconstitute scientific judgement and case formula as either practical-moral and rational-technical actions. via making social clinical paintings extra available and significant to pros in perform, it develops the case for a extra real looking method of the various reasoning approaches occupied with scientific judgement. medical Judgement within the wellbeing and fitness and Welfare Professions has been written for educators, managers, practitioners and complex scholars in wellbeing and fitness and social care. it may additionally entice people with an curiosity within the research of institutional discourse and ethnographic study.

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Extra info for Clinical Judgement in the Health and Welfare Professions: Extending the Evidence Base

Example text

They cannot reinvent themselves as a result. They do not come to see themselves differently as a consequence of how we describe them. Of course, our actions in relation to these indifferent kinds may have unintended consequences – resistant bacteria are a consequence of our use of antibiotics, but the bacteria’s resistance is not political! Of course, as we show in Chapter 4, doing science is itself a social business. For example, the interpretation of the results of experiments and so forth may be subject to debate and rely on strategies of argumentation or persuasion, and new ideas may be affected by established ways of thinking.

The decisions of health authorities were based on questions of cost-efficiency, effectiveness and quality of service (Flynn and Williams 1997; Ham, 1999), with some of their decisions proving controversial, such as the case of Jaymee Bowen (child B), who was denied a further bone marrow transplant to treat her leukaemia because the odds of a positive outcome were considered to be unacceptably low (see New 1996). These technologies eroded certain aspects of medical autonomy as it had been traditionally understood (Flynn 1992; Harrison and Pollitt 1994; Harrison and Ahmed 2000).

As a source of such evidence, the randomized controlled trial (RCT) has become constructed as the sine qua non of medical research. That is to say, evidence-based practice has a clear ‘hierarchy of evidence’ (Canadian Task Force 1979), with RCTs at the top ostensibly providing a ‘gold standard’ against which all else can be judged. This would also appear to be the prescription for social care, as Gomm (2000: 51) asserts: ‘The properly conducted, correctly interpreted RCT (randomised controlled trial) is superior to any other method for producing evidence about cause and effect.

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