The growth of evidence-based medicine has occurred against a backdrop of health care reform, managed care, cost containment and quality improvement, and clinicians have been urged to adopt the rigours of science while remaining true to their 'clinical judgement'. This tension - between efforts to make medical practice more scientific and the suspicions of many clinicians - has caused one of the greatest practical and ethical challenges in the history of the health professions. This incisive book reviews the history and conceptual origins of evidence-based practice, and discusses key ethical issues that arise in clinical practice, public health and health policy. Essential reading for all physicians, and practitioners in epidemiology and public health, it will also be suitable as a text in medical and public health school courses on evidence-based practice.