Medicine and Political Science: Parallel Lessons in Methodological Excess

Our discipline has recently been the site of a number of meta-theoretical debates about what we do and how we might do it differently. These discussions have been so animated that even outsiders have taken notice: the Perestroika movement continues to make news, generating self-consciousness and reflection about our professional endeavors. In this article, we consider developments in a neighboring discipline. Political analysts have long mined other fields of inquiry for theoretical, epistemological, and methodological nuggets. While some have embraced insights from psychology, anthropology, economics, or sociology, more typically—as the word “science” implies—we turn for inspiration to the natural sciences. In these fields, we may find grounds for both admiration (for what they have achieved, intellectually and practically) and envy (for highlighting the built-in limitations of political analysis). If some aspects of inquiry from the natural sciences deserve emulation, others do not. Rather, the experience of a neighboring discipline may sound a note of caution about parallel developments in our own. In this article, we argue that recent shifts in the conduct of medical research should sound this warning. In medicine, we have an allegory for what has occurred in political science: dramatic advances in research technologies have created inflexible hierarchies of data collection that, in the end, can inhibit productive inquiry. To flesh out this argument, we focus on the implications of the “Evidence- Based Medicine” (EBM) movement. We find that while EBM has spurred important advances in public health, it has also created a new methodological orthodoxy that privileges a priori certain types of data over others. As a result of this orthodoxy, patient care has in critical ways suffered and important research questions have been elided. We proceed as follows. After a brief sketch of EBM’s characteristics, we outline how it departs from pre-EBM medical research and practice. Then, we consider a balance sheet on EBM; while it has generated important medical advances, as a mode of inquiry it neither has had a monopoly on such advances, nor have its consequences been uniformly positive. In the fourth section, we consider implications for comparable processes in political science, highlighting the potential for “methodological excess,” i.e., method-driven, rather than problem-driven, research. Finally, we conclude by relaxing the assumption that medical research and political research are comparable and consider some sobering implications that follow.