Evidence-Based Policy or Policy-Based Evidence?
Is evidence-based policy no more than a useful myth? Political science professor John Boswell clearly thinks so. And current headlines might suggest he’s right. Facts get twisted. Policymakers do what they want.
Boswell explains his view in a paper that Governance will publish soon. For a case study, he uses bariatric surgery guidelines recently adopted by Britain’s National Institute for Clinical Excellence (NICE).
He starts with the position that evidence-based policy is a fiction. Certainly, much has been written about living in a “post-truth era.” But he goes on to describe three functions that make evidence-based policymaking useful – even if it’s only a myth.
1. An Epistimic Function: A Shifting Fix on the Facts
Knowledge keeps growing. Constantly shifting facts create a challenge for making decisions. For policymakers to use facts, they need a tool for getting at least a temporary fix on where they stand. When NICE drafted evidence-based guidelines for bariatric surgery, Boswell says, it forged a “short-term compromise.” NICE made guidelines that “suitably reflect the evidence-based arguments of proponents of bariatric surgery.” But it also left “sufficient ‘wriggle room’ for service providers, commissioners, and clinicians less swayed by the weight of evidence.”
2. A Pragmatic Function
Have we mentioned that obesity is complex? In the face of all of the complexity that obesity presents, evidence-based policymaking offers a pragmatic way forward. Boswell says it acts as a “principled instrument” for interactions between policymakers and the stakeholders. Without it, action and change might not be possible.
3. A Procedural Function
Boswell says that arguments about values and what counts as knowledge are inevitable. A shared faith in the myth of evidence-based policymaking – even if it is a myth – provides the underpinning for outcomes that people can accept, whether they win or lose.
People, Not Facts, Make Policy
Interestingly enough, Boswell’s case study does not display a very good understanding of bariatric surgery. He includes only comments about gastric bands, which, of course, have fallen out of common use. Perhaps he unwittingly illustrates the constant flux of evidence. Perhaps he’s illustrating the peripheral nature of facts to policymaking.
In any event, Boswell has a point. Evidence does not make policy decisions for us. People apply their values and biases to assign meaning to the evidence before them. Decision making requires both reason and emotion. And most often, emotion carries the day.
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April 19, 2017