In the second of two articles the author discusses non-scientific factors that influence the application of results from clinical research in clinical practice. This step is essentially a matter of judgement. The factors considered include selective use of research results, protection of special interests, the impact of the "last case", the therapeutical imperative and consensus conferences. Attention is drawn to the importance of market leaders and the relationship between scientists and the pharmaceutical industry. The absence of price incentives is underlined. It is pointed out that clinical research is a vital element in the long-term efforts to secure high quality service to patients.