The practice of modern medicine is the application of science, the ideal of which has the objective of value-neutral truth. The reality is different: practice varies widely between and within national medical communities. Neither evidence from randomised controlled trials nor observational methods can dictate action in particular circumstances. Their conclusions are applied by value judgments that may be impossible to specify in “focal particulars”. Herein lies the art which is integral to the practice of medicine as applied science.
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John Saunders (2000) studied this question.
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