Epistemic humility and medical practice: Translating epistemic categories into ethical obligations

Journal of Medicine and Philosophy

Volumn 37, Issue 1, 2012, Pages 28-48

  Schwab, Abraham ^a  

^a INDIANA UNIVERSITY PURDUE UNIVERSITY FORT WAYNE   (United States)

Author keywords

epistemic humility; medical practice; uncertainty

Indexed keywords

ARTICLE; DECISION MAKING; DOCTOR PATIENT RELATION; ETHICS; HEALTH CARE PERSONNEL; HUMAN; INFORMED CONSENT; MEDICAL RESEARCH; PATIENT CARE; PHILOSOPHY; PHYSICIAN; PRACTICE GUIDELINE; UNCERTAINTY;

BIOMEDICAL RESEARCH; DECISION MAKING; HEALTH PERSONNEL; HUMANS; INFORMED CONSENT; PATIENT CARE; PHILOSOPHY, MEDICAL; PHYSICIAN-PATIENT RELATIONS; PHYSICIANS; PRACTICE GUIDELINES AS TOPIC; UNCERTAINTY;

EID: 84856479959     PISSN: 03605310     EISSN: 17445019     Source Type: Journal    
DOI: 10.1093/jmp/jhr054     Document Type: Article

References (44)

1. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. 2002. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). The Journal of the American Medical Association 288:2981-97.
2. Adler, J. E. 2005. Reliabilist justification (or knowledge) as a good truth-ratio. Pacific Philosophical Quarterly 86:445-58.
3. American College of Surgeons. 1994. Statement on emerging surgical technologies and the evaluation of credentials. The Bulletin of the American College of Surgeons 79:40-1.
4. Baumann, A. O., R. B. Deber, and G. G. Thompson. 1991. Overconfidence among physicians and nurses: The "micro-certainty, macro-uncertainty" phenomenon. Social Science and Medicine 32:167-74.
5. Bishop, M. 2000. In praise of epistemic irresponsibility: How lazy and ignorant can you be? Synthese: An International Journal for Epistemology, Methodology and Philosophy of Science 122:179-208.
6. Bishop, M., and J. D. Trout. 2002. Epistemology and the psychology of human judgment. Oxford: Oxford University Press.
7. Brady, M., and D. Pritchard. 2006. Epistemic virtues and virtue epistemology. Philosophical Studies: An International Journal for Philosophy in the Analytic Tradition 130:1-8. (Pubitemid 44235420)
8. Brody, H. 1989. Transparency: Informed consent in primary care. The Hastings Center Report 19:5-9.
9. Corlett, J. A. 2008. Epistemic responsibility. International Journal of Philosophical Studies 16:179-200.
10. Darley, J. M., and C. Daniel Batson. 1973. From Jerusalem to Jericho: A study of situational and dispositional variables in helping behavior. Journal of Personality and Social Psychology 27:100-119.
11. Everett, E., H. Tamimi, B. Greer, E. Swisher, P. Paley, L. Mandel, and B. Goff. 2003. The effect of body mass index on clinical/pathologic features, surgical morbidity, and outcome in patients with endometrial cancer. Gynecologic Oncology 90:150-7. (Pubitemid 37338090)
12. Fischoff, B. 1975. Hindsight is not equal to foresight: The effect of outcome knowledge on judgment under uncertainty. Journal of Experimental Psychology: Human Perception and Performance 1:288-99.
13. Fisher, J. A. 2006. Procedural misconceptions and informed consent: Insights from empirical research on the clinical trials industry. Kennedy Institute of Ethics Journal 16:251-68. (Pubitemid 44621471)
14. Flood, A. T. 2008. Epistemic badness. Journal of Philosophical Research 33:253-62.
15. Gawande, A. 2002. Complications: A surgeons notes on an imperfect science. New York: Henry Holt and Company.
16. General Medical Council (GMC). 2008. Prescribing unlicensed medicines. Available: http://www.gmc-uk.org/guidance/ethical-guidance/prescriptions-faqs. asp#9 (Accessed March 9, 2010).
17. Goldman, A. 1986. Epistemology and cognition. Cambridge, MA: Harvard University Press.
18. Grenberg, J. 2007. Courageous humility in Jane Austens "Mansfield Park." Social Theory and Practice: An International and Interdisciplinary Journal of Social Philosophy 33:645-666.
19. Hirt, E. R., and K. Markman. 1995. Multiple explanation: A consider-an-alternative strategy for debiasing judgments. Journal of Personality and Social Psychology 69:1069-86. (Pubitemid 126004978)
20. Jonas, E., S. Schulz-Hardt, D. Frey, and N. Thelen. 2001. Confirmation bias in sequential information search after preliminary decisions: An expansion of dissonance theoretical research on selective exposure to information. Journal of Personality and Social Psychology 80:557-71. (Pubitemid 33594514)
21. Jones, J., L. McCullough, and B. Richman. 2005. Informed consent: Its not just signing a form. Thoracic Surgery Clinics 15:451.
22. Katz, J. 1994. Informed consent-Must it remain a fairy tale? The Journal of Contemporary Health Law And Policy 10:69-91.
23. Kirtane, A., A. Gupta, S. Iyengar, J. Moses, M. Leon, R. Applegate, B. Brodie, E. Hannan, K Harjai, L. O. Jensen, et al. 2009. Safety and efficacy of drug-eluting and bare metal stents: Comprehensive meta-analysis of randomized trials and observational studies. Circulation 119:3198-206.
24. Klayman, J., and Y. Ha. 1987. Confirmation, disconfirmation, and information in hypothesis testing. Psychological Review 94:211-28.
25. Koehler, D. J. 1991. Explanation, imagination, and confidence in judgment. Psychological Bulletin 110:499-519.
26. Lord, C., L. Ross, and M. R. Lepper. 1979. Biased assimilation and attitude polarization: The effects of prior theories on subsequently considered evidence. Journal of Personality and Social Psychology 37:2098-109.
27. Louden, R. B. 2007. Kantian moral humility: Between Aristotle and Paul. Philosophy and Phenomenological Research 75:632-9.
28. Moore, D., and P. Healy. 2008. The trouble with overconfidence. Psychological Review 115:502-17.
29. Nickerson, R. 1998. Confirmation bias: A ubiquitous phenomenon in many guises. Review of General Psychology 2:175-220. (Pubitemid 128549158)
30. Pronin, E., T. Gilovich, and L. Ross. 2004. Objectivity in the eye of the beholder: Divergent perceptions of bias in self versus others. Psychological Review 111:781-99. (Pubitemid 38883581)
31. Roddy, E. 2004. Bupropion and other non-nicotine pharmacotherapies. British Medical Journal 328:509-11.
32. Schwab, A. P. 2008a. Epistemic trust, epistemic responsibility, and medical practice. The Journal of Medicine And Philosophy 33:302-20.
33. -. 2008b. The patients piece of the informed consent pie. Virtual Mentor 10:527-30.
34. -. 2008c. Putting cognitive psychology to work: Improving decision-making in the medical encounter. Social Science and Medicine 67:1861-9.
35. Sindaco, D. D., G. Pulignano, G. Minardi, A. Apostoli, L. Guerrieri, M. Rotoloni, G. Petri, et al. 2007. Two-year outcome of a prospective, controlled study of disease management programme for elderly patients with heart failure. Journal of Cardiovascular Medicine 8:324-9. (Pubitemid 46634071)
36. Stephens, T. D., and R. Brynner. 2001. Dark remedy: The impact of thalidomide and its revival as a vital medicine. Cambridge, MA: Perseus.
37. Straus, S., and R. B. Haynes. 2009. Managing evidence-based knowledge: The need for reliable, relevant and readable resources. Canadian Medical Association Journal 180:942-5.
38. Trout, J. D. 2002. Scientific explanation and the sense of understanding. Philosophy of Science 69:212-33.
39. Vandenbroucke, J. 2009. The HRT controversy: Observational studies and RCTs fall in line. Lancet 373:1233-5.
40. Vaughn, L. A., and G. Weary. 2003. Causal uncertainty and correction of judgments. Journal of Experimental Social Psychology 39:516-24. (Pubitemid 37123670)
41. Veatch, R. 2009. Patient, heal thyself: How the new medicine puts the patient in charge. Oxford: Oxford University Press.
42. Waller, B., and R. Repko. 2008. Informed consent: Good medicine, dangerous side effects. Cambridge Quarterly Of Healthcare Ethics: CQ: The International Journal Of Healthcare Ethics Committees 17:66-74.
43. Wason, P. C. 1960. On the failure to eliminate hypotheses in a conceptual task. Quarterly Journal of Experimental Psychology 12:129-40.
44. Whittle, A. 2006. On an argument for humility. Philosophical Studies: An International Journal for Philosophy in the Analytic Tradition 130:461-97. (Pubitemid 44328187)