 In general, within the narrower realm of medical decision-making (which we take to include decisions to participate in clinical research) the two terms are roughly interchangeable or should be. For this reason, many writers adopt the policy of using the terms interchangeably while signaling recognition that this breaks with certain conventions. This usually is done by adding a minor proviso or caveat at the beginning of a discussion to that effect (Charland 2002: 37 note 1; Checkland 2001: 53, note 2; National Bioethics Advisory Commission 1998: Ch 1, note 4). The strategy has the virtue of avoiding the cumbersome repeated substitution of one term for the other in or across discussions where both are used. But it can also inadvertently perpetuate confusion of just the sort it is meant to obviate. For the rest of this entry the terms will be used interchangeably.