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What makes evidence‐based policy making such a useful myth? The case of NICE guidance on bariatric surgery in the United Kingdom
Author(s) -
Boswell John
Publication year - 2018
Publication title -
governance
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.46
H-Index - 76
eISSN - 1468-0491
pISSN - 0952-1895
DOI - 10.1111/gove.12285
Subject(s) - excellence , nice , skepticism , evidence based policy , politics , mythology , work (physics) , health policy , public administration , scientific evidence , political science , medicine , health care , law , alternative medicine , epistemology , computer science , engineering , history , mechanical engineering , philosophy , pathology , programming language , classics
There is widespread skepticism among policy scholars and practitioners about the move to rationalize policy making: The naive vision of “evidence‐based policy” is often contrasted with the reality of “policy‐based evidence.” Yet, the language of evidence‐based policy making (EBPM) continues to dominate policy debate about complex and contested issues. In this paper, I explore this apparent paradox by looking at what makes EBPM such a useful myth for all sorts of policy actors. I do so with reference to the pioneering work of the National Institute for Health and Care Excellence (NICE), focusing specifically on its work in relation to bariatric surgery, a suite of controversial and drastic weight loss procedures. I show that the myth of EBPM has political, pragmatic, and procedural utility in practice, allowing the organization to set and administer guidelines on this uncertain, complex, and contested treatment in ways that sustain buy‐in and enable ongoing contestation.