Over the last fifty years, several new paradigms have
developed in medical epistemology.  The traditional
practices of clinical judgment and causal scientific
reasoning have been supplemented with “Evidence-Based
Medicine” (including the techniques of randomized controlled
trials, formal decision sciences and meta-analysis), “Expert
Consensus” (often attained in Consensus Conferences)
and “Narrative Medicine” (with roots in humanistic medical
traditions).  Each of these epistemological paradigms has
unsettled methodological questions of its own, as well as
questions about how it relates to the other paradigms.  My
presentation aims to decipher the often conflicting
recommendations of these different paradigms.