Moral‐Epistemic Dilemmas: The Case of Gender in Medical Diagnosis

ABSTRACT

In this paper, I describe what I call “moral‐epistemic dilemmas”. The central features of such cases are: (i) an agent is obligated to take a view (i.e., they cannot simply refrain from drawing a conclusion); (ii) the view the agent takes is action‐guiding; (iii) there are competing options for how the agent should evaluate evidence (and what information they should consider as evidential) when taking a view; (iv) there are both moral and epistemic costs associated with each of their competing options. To illustrate this phenomenon, I use the example of statistical inferences based on gender in medical diagnosis. In such cases, I argue, there are costs to both accuracy and fairness if a physician applies gender‐based generalizations to a female patient, and likewise potential costs to both accuracy and fairness if a physician fails to apply such generalizations. The net result is a dilemma in which both horns have epistemic and moral risks.