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Rapid response to:

Education And Debate Qualitative research in health care

Assessing quality in qualitative research

BMJ 2000; 320 doi: (Published 01 January 2000) Cite this as: BMJ 2000;320:50

Rapid Response:

Antirealists and Qualitative Research

Dear Editor:

We appreciated the paper by Mays and Pope but were struck by their
indulgent treatment of the antirealist position.(1) Antirealist
qualitative researchers contend there is no "social" reality or truth that
is independent of the observer. Antirealists, a species of post-
modernists, scoff at those naive enough to believe in the physical
reality of social world: "what the parochial view in the social,
behavioral, and service sciences has touted as ‘science' is historical and
practical myth...."(2) Presumably "social" reality consists of the
interactions of human beings, i.e., spoken or written words, and all human
actions that relate to other humans. Thus the antirealists apparently
would contend that this letter has no reality. Antirealists thus fall
headlong into self-contradiction. If no utterances, presumably including
their own, have reality, why should one read what they write? Further,
why should one pay any attention to the work of supposedly "scientific"
researchers who deny the independent reality of what they research?

The antirealist view seems to be at best an excuse for sloppy work.
Antirealists have argued that bias in research is good, "not something to
be eliminated, but is a productive element, a foundation for formulating
questions and understanding answers in the process of research."(3) They
have asserted that the traditional notions of methodologic rigor, "the
classical cannons of reliability, validity, and objectivity," are
irrelevant to their kind of qualitative research, to the point that a
"powerful case can be made for methodological anarchy...!"(4) In
retreating to ancient subjectivist attitudes, antirealists have renounced
the rigor, self-discipline, humility in the face of evidence, and
willingness to risk failure and blind alleys that the scientific attitude
necessarily comprises.

Alan Sokal, the physicist whose parody of post-modernism in science
received wide attention, said it well. First he decried "a particular
kind of nonsense and sloppy thinking: one that denies the existence of
objective reality."(5) Then he wrote "intellectually, the problem with
such doctrines is that they are false. There is a real world; its
properties are not merely social constructions; facts and evidence do
matter. What sane person would contend otherwise?"

We applaud the efforts of Pope and May to bring more rigor to the
design, execution, and review of qualitative research. We fear, however,
that responsible qualitative researchers will have trouble convincing
others of the value of their field until they disavow the pseudo-
philosophic nonsense of antirealism.

Roy M. Poses MD

Brown University Center for Primary Care and Prevention
Pawtucket, RI, USA

Norman J. Levitt PhD

Department of Mathematics,
Rutgers University,
New Brunswick, NJ, USA


1. Mays N, Pope C. Assessing quality in qualitative research. Brit
Med J 2000; 320: 50-52.

2. Gubrium JF. Qualitative research comes of age in gerontology.
Gerontologist 1992: 32: 581-582.

3. Berkwits M, Aronowitz R. Different questions beg different
methods. J General Internal Medicine 1995; 10: 409-410.

4. Henwood KL, Pidgeon NF. Qualitative research and psychological
theorizing. Br J Psychology 1992;83:97-111.

5. Sokal A. A physicist experiments with cultural studies. Lingua
Franca 1996; 6: 62-64.

Competing interests: No competing interests

26 January 2000
Roy M Poses
Brown University Center for Primary Care and Prevention
Pawtucket, RI, USA