Faking a difference: evidence-based nursing and the illusion of diversity

Abstract

Whilst it is desirable for the dominant paradigm (discourse) in any discipline to be seen to be encouraging diversity, I will argue in this paper that the result of real diversity is to decentralize power and strengthen the challenges to that discourse. It is therefore in the interests of the dominant discourse (if it wishes to remain dominant) to act to neutralize the power of its competitors by forcing them to conform to the rules of the dominant discourse. In this way, the illusion of diversity is maintained, but its power for radical change is greatly diluted.

In deconstructing some of the most influential ‘texts’ (in the broader sense of the term) of evidence-based nursing, I have attempted to show that the usual way of divesting competing discourses of their power is through an assimilation into the dominant discourse in the name of diversity. However, such assimilation is, in reality, more akin to an aggressive takeover bid which maintains the rules, values and culture of the dominant discourse. For example, when qualitative bids for research funding are judged according to the rules of quantitative research, that is, according to their generalizability, sample size, and so on, the outcome is inevitably to their disadvantage. Simply by agreeing to play, any competing discourse accepts the rules of the game that are designed to deny fair competition. The rhetoric of diversity therefore masks a strategy for maintaining power which can only be challenged by (Lyotard's notion of) the philosopher, who attempts to expose the inequality inherent in it.