Ethics in numbers: Auditing cleft treatment in Mexico and beyond

Samuel Taylor-Alexander

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)


Plastic surgeons around the globe are implementing projects that mix audit with medical research to ensure and improve the level of care offered to patients with cleft lip and palate. Drawing on recent literature on "audit culture" and the global growth of "performance indicators" as a form of governance, I demonstrate the conjugation of ethics and the production of numerical indicators in cleft treatment. By standardizing documentation, cleft treatment audit programs facilitate evidence-based medicine and a form of reflexive self-governance. However, the abstraction that accompanies standardization is amplified as corollary data practices travel. In emerging as the answer to improving treatment, these projects lock out the politico-economic factors that mediate medical care in resource poor settings. This danger is compounded by the tendency of numerical governance to replace political conversation with technocratic expertise.

Original languageEnglish
Pages (from-to)385-402
Number of pages18
JournalMedical Anthropology Quarterly
Issue number3
Publication statusPublished - 2017
Externally publishedYes


  • Audit
  • Cleft lip and palate
  • Ethics
  • Mexico
  • Reconstructive plastic surgery

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