Rational deliberation to consensus is a powerful ideal, promising both objectivity and democracy. This chapter explores reasons for concern about the rationality and democracy of group deliberation in practice, and makes recommendations for improvement. It reveals that consensus conferences are social epistemic rituals. The chapter also looks at the differences between consensus on a political matter and consensus on a scientific matter. Forming a consensus on scientific matters is generally less important than on political matters, but is sometimes needed to maintain epistemic authority, especially in medical contexts.