Evidence-based medicine (EBM) promises to make the practice of medicine more fully `rational', thereby increasing medicine's reliability and improving patient health outcomes. However, intractable ethical and epistemic problems with applying a model of rationality that privileges quantifiable `evidence' in medical practice - evidence often at odds with nonquantifiable patient experiences, values and preferences - have prompted some within the medical community to condemn EBM. This article analyzes textual evidence from the medical literature as the medical community's effort to rhetorically renegotiate a new model of rationality, one which both preserves rationality's promise to protect medical decision making from the dogmatic, subjective and arbitrary and permits nonquantifiable patient experiences, values and preferences to play a legitimate role in rational diagnostic and therapeutic decision making.
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