Abstract

We thank the authors for their contributions, which have been generally very supportive of our original article. Rather than comment on those infrequent issues with which we disagree, we have decided to focus on one of the main points made by Dr. Lehoux in her commentary. She has appropriately chastised us for underemphasizing the importance of cultural and political issues in healthcare. To quote her: "- one questionable aspect of Laupacis and Evans' paper is that it seems to assume that clinicians, radiologists and patients are currently behaving irrationally and that science is the most desirable incarnation of rationality. As mentioned earlier, radiologists, clinicians, policymakers and the public may all have reasons to adhere to various views about the value of diagnostic imaging. That their views do not fit neatly with what researchers see as appropriate does not simply reflect ignorance or intellectual laziness on their part." She further states, "Scientific rationality is not to be abandoned; but it should be rooted in and articulated with social, cultural and political rationalities."