Health care policy in theory and practice: a review of the process as a product of rational decision-making.

Decisions are not made in a vacuum. Both theories and practical circumstances influence how reason and decision-making are conceived. In this article, the focus is on organizations and their impact on shaping the decision-making process. Organizational theories, management philosophies, and structural considerations are reviewed, with emphasis placed on how they influence the search for information, the conceptualization of data, the possible uses of knowledge, and the formation of behavioral goals. Accordingly, decision-making is contextualized; organizational assumptions are linked to the reasonableness of a decision. As modern writers say, the "taken-for-grantedness" of an organization is illustrated to be tied inextricably to the nature of reason and assessments of rationality.