clinicians are often faced with management problems for which there are
no answers at hand, either because there is no literature that gives
definite answers, because there are conflicting data in the literature,
or because the circumstances surrounding the clinical cases are unusual
enough to prevent the application of existing scientific knowledge.
When faced with these problems, clinicians are forced to make decisions
based on a logical extension of their scientific knowledge into
uncharted clinical waters. They are forced to make judgments based on
the conviction of their speculations and on prior experiences.