La volonté de quantifier. Conceptions de la mesure de l'activité médicale

The will to quantify. Conceptions of measurement of medical practice. (A. Ogien). Because one usually admits that numbers give an objective and impersonal description of events and procedures, measurement is often thought of as an operation that fuels public debate and helps reaching an agreement. Considering the role devoted to quantification in modern policy making (founded as it is on public management principles), this article discusses the soundness of such an ideal view of measurement. Taking the example of French health policy, it describes how the will to quantify (e.i. the compulsion to justify a decision by appealing to the supposedly objective knowledge given by statistical figures) displayed by politicians and civil servants can be opposed by members of the medical profession who develop their own system of measurement to challenge the one the Government tries to settle up to cut the cost of health care. An analysis of this conflict, which incidentally sheds light on the consequences of the use of quantification on political reasoning, shows that measurement does not necessarily bring about consensus: it can also contribute to reinforce competing legitimacies.Ogien Albert. La volonté de quantifier. Conceptions de la mesure de l'activité médicale. In: Annales. Histoire, Sciences Sociales. 55ᵉ année, N. 2, 2000. pp. 283-312