Preserving intellectual freedom in clinical medicine.

medical practice; rather in significant part it is engaged in special interest advocacy, pursuing and preserving social power. The concept of excellence is a component of the ideological justification of that role’ [ 3 , p. 11]. Holman identified a decline in intellectual freedom as a major source of the ‘excellence deception’, which perpetuates prevailing practices, deflects criticism and insulates the profession from alternative views and social relations that would illuminate and improve health care. There are indeed increasing threats to the preservation of intellectual freedom in clinical medicine.