Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/17851
Title: Moral entrepreneurship, the power-knowledge nexus, and the Cochrane "crisis"
Authors: Greenhalgh, T
Ozbilgin, MF
Prainsack, B
Shaw, S
Keywords: evidence‐based medicine;philosophy of medicine;systematic reviews
Issue Date: 18-Mar-2019
Publisher: Wiley
Citation: Greenhalgh, T. et al. (2019) 'Moral entrepreneurship, the power-knowledge nexus, and the Cochrane “crisis”', Journal of evaluation in clinical practice, 25 (5), pp. 717 - 725. doi: 10.1111/jep.13124.
Abstract: Background: In 2018, a so-called crisis developed in the international network of systematic reviewers known as Cochrane. It was widely depicted in terms of two competing narratives—“bad behaviour” by one member of Cochrane's Governing Board and scientific and moral decline within Cochrane. Objective: Our goal was to distil insights on the structural issues underpinning the crisis, without taking a definitive position on the accuracy of either narrative. Approach and dataset: In this paper, we draw on (among other theories) Becker's notion of moral entrepreneurship and Foucault's conceptualisation of power to analyse the claims and counterclaims made by different parties. Our dataset consisted of publicly available materials (blogs, journal articles, newspaper articles) to end 2018, notably those relating to the expulsion of one Governing Board member. Main findings: Both narratives include strong moral claims about the science of systematic review and the governance of scientific organizations. The expelled individual and his supporters defined good systematic reviews in terms of a particular kind of methodological rigour and elimination of bias, and good governance largely in terms of measures to achieve independence from industry influence. Most of Cochrane's Governing Board and their sympathizers evaluated systematic reviews according to a broader range of criteria, incorporating factors such as attention to relationships among reviewers and reflexivity and dialogue around scientific and other judgements. They viewed governance partly in terms of accountability to an external advisory group. Power-knowledge alignments in Cochrane have emerged from, and contributed to, a particular system of meaning which is now undergoing evolution and challenge. Conclusion: Polarizing Cochrane's “crisis” into two narratives, only one of which is true, is less fruitful than viewing it in terms of a duality consisting of tensions between the two positions, each of which has some validity. Having framed the conflict as primarily philosophical and political rather than methodological and procedural, we suggest how Cochrane and its supporters and critics might harness their tensions productively.
Description: Correction added on 8 November 2019 after first online: A paragraph, which was not supported by its stated source, has been removed in this version. Please refer to Corrigendum JEP13227. Correction added on 23 August 2019, after first online publication: Wellcome Trust Senior Investigator Award to TG, Grant no: WT104830MA has been added in this version. The copyright line for this article was changed on 10 January 2020 after original online publication
URI: https://bura.brunel.ac.uk/handle/2438/17851
DOI: https://doi.org/10.1111/jep.13124
ISSN: 1356-1294
Appears in Collections:Brunel Business School Research Papers

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