Medical guidelines, finding the evidence

Doctors are powerful people. They take decisions that affect people’s lives, and work in situations of great stress and pressure. Medical guidelines provide doctors with tools to make decisions on treating patients that are based on the best available evidence. We know little about how these guidelines are made however. Who drafts them, and how do they do it? What is the socio-legal world such a guideline lives in?

My fieldwork in the Netherlands and England, travelling around these countries from edge to edge, taught me that powerful people reside in unexpected locations: in musty old buildings, tucked away in hidden corners, in colourless rooms overlooking a steely sky. Even so everyone I met was passionate in talking about their work.

Describing a vision of making healthcare work for doctors and patients, mindful of the compromises that have to be struck to make incremental process towards that goal possible. Their unassuming surroundings hide the political nature of their work, it hides the interests and money that is at stake in the decisions they take.

Peering into such a world so as to be able to go beyond the boring text of these guideline documents is one of the (many) joys of socio-legal research.