Epistemic burdens and the incentives of surrogate decision-makers

Parker Crutchfield, Scott Scheall

    Research output: Contribution to journalArticlepeer-review

    4 Scopus citations


    We aim to establish the following claim: other factors held constant, the relative weights of the epistemic burdens of competing treatment options serve to determine the options that patient surrogates pursue. Simply put, surrogates confront an incentive, ceteris paribus, to pursue treatment options with respect to which their knowledge is most adequate to the requirements of the case. Regardless of what the patient would choose, options that require more knowledge than the surrogate possesses (or is likely to learn) will either be neglected altogether or deeply discounted in the surrogate’s incentive structure. We establish this claim by arguing that the relation between epistemic burdens and incentives in decision-making is a general feature of surrogate decision-making. After establishing the claim, we draw out some of the implications for surrogate decision-making in medicine and offer philosophical and psychological explanations of the phenomenon.

    Original languageEnglish (US)
    Pages (from-to)613-621
    Number of pages9
    JournalMedicine, Health Care and Philosophy
    Issue number4
    StatePublished - Dec 1 2019


    • Epistemology
    • Ignorance
    • Surrogate decision-making

    ASJC Scopus subject areas

    • Health(social science)
    • Education
    • Health Policy


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