Translating texts into care: Classification issues raised by evidence-based practice in t he UK health sector

Abstract

The problem of translating texts into care (where practitioners are mandated to base their work on the literary corpus) has been construed in several ways: in terms of time management, in terms of physical access, and in terms of adequate surrogates for texts (translations) like indexes, abstracts, systematic reviews. In some cases, there may be a deeper problem of incommensurability. The nursing profession in the UK, a newly professionalized group faced with government mandates to base their practice on medical evidence, may constitute such a case. EBM (evidence-based medicine, or 'text') poses challenges for nurses (proponents of 'caritas'). This paper reviews epistemological and ontological problems identified in previous research on evidence-based nursing practice, which suggests that incommensurability of the medical and nursing domains is an issue. An additional surrogate for the medical corpus, the clinical guideline, is discussed. When based on inclusive consultation, this may prove to be a hospitable 'translation artefact' for groups whose domains are in conflict. Drawing on theoretical work on 'translation' by Bowker and his colleagues, by Berkenkotter and by Latour, the author explores the status of the clinical guideline as a translation artefact: it is a novel hybrid, which links retrieval, classification and action by combining different warrants.