'It is not a pill'

Uncertainties and promises in the entanglements of qualitative and quantitative medical research

Abstract

Person-centered care seeks to improve health care by recognizing the individual patient’s unique experience and by acknowledging the patient as an active and responsible participant in their own care. It is also conceptualized as a reaction to evidence-based medicine, opposing its alleged reductionist and exclusionary tendencies.

Therefore, person-centered care is often conceived as different from evidence-based medicine, taking into account the combined biological, psychological and social identity of the patient which evidence-based medicine reduces to a set of signs and symptoms. In this article, I analyze a paradoxical case in which a randomized controlled trial was used to evaluate person-centered care. Drawing on five interviews with researchers involved in this trial and on research documents and articles, I examine the entanglement of person-centered-care and evidence-based medicine from an STS perspective of standardization, uncertainties and promises.

I first discuss the uncertainties and promises that emerge when trying to follow a research protocol. Second, the article illustrates the uncertainties and possibilities in knowing exactly what one measures. Finally, the article discuss the creation of a standard person. The article concludes that while the relation between person-centered care and evidence-based medicine is more complex than we might assume, the randomized controlled trial also transformed person-centered care in the process of evaluating it.