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Department of Radiation Oncology, Southern California Kaiser Permanente Medical Group, Los Angeles, CA, USA. robert.a.kagan@kp.org
The management of patients with cancer teaches us the worth of logical thought, the advantage of flexibility of thinking and the thrill of occasionally doubting the experts. Asking questions and learning from the answers teaches us how to think. On the other hand, searching for the single best treatment, when no single treatment works for all patients, leads to a sort of intellectual tyranny that has numerous names: the gold standard, the community standard, best practice, and evidence-based medicine (EBM), with the implication that to take an alternative management route is substandard and unethical.
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