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Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia

Australian government planning promotes evidence-based action as the overarching goal to achieving health equality for Aboriginal and Torres Strait Islander populations. However, an inequitable distribution of power and resources in the conduct of evidence-based practice produces a policy environmen...

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Autores principales: Luke, Joanne, Verbunt, Ebony, Zhang, Angela, Bamblett, Muriel, Johnson, Gabrielle, Salamone, Connie, Thomas, David, Eades, Sandra, Gubhaju, Lina, Kelaher, Margaret, Jones, Amanda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9185488/
https://www.ncbi.nlm.nih.gov/pubmed/35680132
http://dx.doi.org/10.1136/bmjgh-2022-009167
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author Luke, Joanne
Verbunt, Ebony
Zhang, Angela
Bamblett, Muriel
Johnson, Gabrielle
Salamone, Connie
Thomas, David
Eades, Sandra
Gubhaju, Lina
Kelaher, Margaret
Jones, Amanda
author_facet Luke, Joanne
Verbunt, Ebony
Zhang, Angela
Bamblett, Muriel
Johnson, Gabrielle
Salamone, Connie
Thomas, David
Eades, Sandra
Gubhaju, Lina
Kelaher, Margaret
Jones, Amanda
author_sort Luke, Joanne
collection PubMed
description Australian government planning promotes evidence-based action as the overarching goal to achieving health equality for Aboriginal and Torres Strait Islander populations. However, an inequitable distribution of power and resources in the conduct of evidence-based practice produces a policy environment counterintuitive to this goal. This context of contemporary evidence-based practice gives legitimacy to ‘expert practitioners’ located in Australian governments and universities to use Western guidelines and tools, embedded in Western methodology, to make ‘evidence’ informed policy and programming decisions about Aboriginal and Torres Strait Islander populations. This method for decision making assumes a positional superiority that can marginalise the important perspectives, experiences and knowledge of Aboriginal Community Controlled Organisations and their processes for decision making. Here we consider the four steps of an evidence review: (1) developing a review question; (2) acquiring studies; (3) appraising the evidence and (4) assessing the evidence, as components of wider evidence-based practice. We discuss some of the limitations across each step that arise from the broader context within which the evidence review is produced. We propose that an ethical and just approach to evidence-based review can be achieved through a well-resourced Aboriginal community controlled sector, where Aboriginal organisations generate their own evidence and evidence is reviewed using methods and tools that privilege Aboriginal and Torres Strait Islander ways of knowing, doing and being.
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spelling pubmed-91854882022-06-16 Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia Luke, Joanne Verbunt, Ebony Zhang, Angela Bamblett, Muriel Johnson, Gabrielle Salamone, Connie Thomas, David Eades, Sandra Gubhaju, Lina Kelaher, Margaret Jones, Amanda BMJ Glob Health Practice Australian government planning promotes evidence-based action as the overarching goal to achieving health equality for Aboriginal and Torres Strait Islander populations. However, an inequitable distribution of power and resources in the conduct of evidence-based practice produces a policy environment counterintuitive to this goal. This context of contemporary evidence-based practice gives legitimacy to ‘expert practitioners’ located in Australian governments and universities to use Western guidelines and tools, embedded in Western methodology, to make ‘evidence’ informed policy and programming decisions about Aboriginal and Torres Strait Islander populations. This method for decision making assumes a positional superiority that can marginalise the important perspectives, experiences and knowledge of Aboriginal Community Controlled Organisations and their processes for decision making. Here we consider the four steps of an evidence review: (1) developing a review question; (2) acquiring studies; (3) appraising the evidence and (4) assessing the evidence, as components of wider evidence-based practice. We discuss some of the limitations across each step that arise from the broader context within which the evidence review is produced. We propose that an ethical and just approach to evidence-based review can be achieved through a well-resourced Aboriginal community controlled sector, where Aboriginal organisations generate their own evidence and evidence is reviewed using methods and tools that privilege Aboriginal and Torres Strait Islander ways of knowing, doing and being. BMJ Publishing Group 2022-06-09 /pmc/articles/PMC9185488/ /pubmed/35680132 http://dx.doi.org/10.1136/bmjgh-2022-009167 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Practice
Luke, Joanne
Verbunt, Ebony
Zhang, Angela
Bamblett, Muriel
Johnson, Gabrielle
Salamone, Connie
Thomas, David
Eades, Sandra
Gubhaju, Lina
Kelaher, Margaret
Jones, Amanda
Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia
title Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia
title_full Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia
title_fullStr Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia
title_full_unstemmed Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia
title_short Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia
title_sort questioning the ethics of evidence-based practice for indigenous health and social settings in australia
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9185488/
https://www.ncbi.nlm.nih.gov/pubmed/35680132
http://dx.doi.org/10.1136/bmjgh-2022-009167
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