ABSTRACT
The clarion call to the perceived clarity of contemporary clinical practice is epitomised by the stream of documents currently being distributed by the Department of Health to support the emergence of primary care groups (PCGs) as the central focus of the reorganisation of the National Health Service (NHS). In particular the document entitled First Class Service is presented with a concealed, but firm, conviction that there is certainty in clinical practice, which is just not getting through to the right people in the right way or at the right time; if it did care would be more effective. These documents represent the politicisation of evidence-based medicine (EBM). This chapter discusses the assumptions that support these three central features of contemporary clinical practice. It argues that there is no absolute universal notion of science, either in philosophical or in historical terms, which should afford a position of unassailable centrality in clinical practice.
