"Doctor Knows Best"

On the Epistemic Authority of the Medical Practitioner


  • Dylan Mirek Popowicz Department of Philosophy, California State University, Sacramento, CA, USA




Epistemic authority, Medical authority, Expertise, Doctor-patient relationship


We often consider medical practitioners to be epistemic authorities: “Doctor knows best,” as the saying goes. The place of expert judgment in evidence-based medicine hierarchies, and the crucial role of patient preferences and values in medical decision-making, however, pose problems for making sense of such authority. I argue that there is an account of such medical epistemic authority that does justice to the complexities of the doctor–patient relationship, while maintaining that medical practitioners hold an epistemically privileged position. Such a view can better inform medical practice by clearly illuminating the distinct roles of patients and doctors in decision-making processes.


Baumberger, Christoph, Claus Beisbart, and Georg Brun. 2017. “What Is Understanding? An Overview of Recent Debates in Epistemology and Philosophy of Science.” In Explaining Understanding: New Perspectives from Epistemology and Philosophy of Science, edited by Stephen Grimm, Christoph Baumberger, and Sabine Ammon, 1–34. New York: Routledge.

Bjerring, Jens Christian and Jacob Busch. 2020. “Artificial Intelligence and Patient-Centered Decision-Making.” Philosophy and Technology 34: 349–71. https://doi.org/10.1007/s13347-019-00391-6.

Carel, Havi and Ian James Kidd. 2014. “Epistemic Injustice in Healthcare: A Philosophical Analysis.” Medicine, Health Care and Philosophy 17: 529–40. https://doi.org/10.1007/s11019-014-9560-2.

Coady, David. 2006. “When Experts Disagree.” Episteme 3, no. 1–2: 68–79. https://doi.org/10.3366/epi.2006.3.1-2.68.

Constantin, Jan and Thomas Grundmann. 2020. “Epistemic Authority: Preemption through Source Sensitive Defeat.” Synthese 197, no. 9: 4109–30. https://doi.org/10.1007/s11229-018-01923-x.

Croce, Michel. 2017. “Expert-Oriented Abilities vs. Novice-Oriented Abilities: An Alternative Account of Epistemic Authority.” Episteme 15, no. 4: 476–98. https://doi.org/10.1017/epi.2017.16.

Dormandy, Katherine. 2018. “Epistemic Authority: Preemption or Proper Basing?” Erkenntnis 83, no. 4: 773–91. https://doi.org/10.1007/s10670-017-9913-3.

Evidence-Based Medicine Working Group. 1992. “Evidence-Based Medicine: A New Approach to Teaching the Practice of Medicine.” JAMA 268, no. 17: 2420–25. https://doi.org/10.1001/jama.1992.03490170092032.

Genin, Konstantin and Thomas Grote. 2021. “Randomized Control Trials in Medical AI: A Methodological Critique.” Philosophy of Medicine 2, no. 1: 1–15. https://doi.org/10.5195/philmed.2021.27.

Goldman, Alvin I. 2011. “Experts: Which Ones Should You Trust?” In Social Epistemology: Essential Readings, edited by Alvin I. Goldman and Dennis Whitcomb, 109–33. New York: Oxford University Press.

Haynes, R. Brian, P.J. Devereaux, and Gordon H. Guyatt. 2002. “Clinical Expertise in the Era of Evidence-Based Medicine and Patient Choice.” BMJ Evidence-Based Medicine 7, no. 2: 36–38. http://dx.doi.org/10.1136/ebm.7.2.36.

Henry, Stephen G. 2006. “Recognizing Tacit Knowledge in Medical Epistemology.” Theoretical Medicine and Bioethics 27: 187–213. https://doi.org/10.1007/s11017-006-9005-x.

Howick, Jeremy. 2011. The Philosophy of Evidence-Based Medicine. Chichester: Wiley-Blackwell, BMJ Books.

Jäger, Christoph. 2016. “Epistemic Authority, Preemptive Reasons, and Understanding.” Episteme 13, no. 2: 167–85. https://doi.org/10.1017/epi.2015.38.

Kukla, Rebecca. 2007. “How Do Patients Know?” Hastings Center Report 37, no. 5: 27–35. https://doi.org/10.1353/hcr.2007.0074.

Matheson, David. 2005. “Conflicting Experts and Dialectical Performance: Adjudicating Heuristics for the Layperson.” Argumentation 19: 145–58. https://doi.org/10.1007/s10503-004-7041-0.

McMyler, Benjamin. 2011. Testimony, Trust, and Authority. New York: Oxford University Press.

Mumpower, Jeryl L. and Thomas R. Stewart. 1996. “Expert Judgement and Expert Disagreement.” Thinking and Reasoning 2, no. 2–3: 191–212. https://doi.org/10.1080/135467896394500.

Priest, Maura. 2017. “Intellectual Humility: An Interpersonal Account.” Ergo 4, no. 16. https://doi.org/10.3998/ergo.12405314.0004.016.

Raz, Joseph. 1988. The Morality of Freedom. Oxford: Clarendon Press.

Rządezcka, Marcin. 2020. “The Philosophy of Expertise in the Age of Medical Informatics: How Healthcare Technology Is Transforming Our Understanding of Expertise and Expert Knowledge.” Studies in Logic, Grammar, and Rhetoric 63, no. 76: 209–25. https://doi.org/10.2478/slgr-2020-0035.

Sackett, David L., William M.C. Rosenberg, J.A. Muir Gray, R. Brian Haynes, and W. Scott Richardson. 1996. “Evidence Based Medicine: What It Is and What It Isn’t.” BMJ 312: 71–72. https://doi.org/10.1136/bmj.312.7023.71.

Schwartz, Barry and Roseanna Sommers. 2013. “Affective Forecasting and Well-Being.” In The Oxford Handbook of Cognitive Psychology, edited by Daniel Reisberg, 704–17. New York: Oxford University Press.

Smith, Richard. 2015. “David Sackett.” BMJ 305. https://doi.org/10.1136/bmj.h2639.

Solomon, Miriam. 2015. “Expert Disagreement and Medical Authority.” In Philosophical Issues in Psychiatry III, edited by Kenneth S. Kendler and Josef Parnas, 60–72. Oxford: Oxford University Press.

Stasiuk, Katarzyna, Yoram Bar-tal, and Renata Maksymiuk. 2016. “The Effect of Physicians’ Treatment Recommendations on Their Epistemic Authority: The Medical Expertise Bias.” Journal of Health Communication 21, no. 1: 92–99. https://doi.org/10.1080/10810730.2015.1049308.

Wieten, Sarah. 2018. “Expertise in Evidence-Based Medicine: A Tale of Three Models.” Philosophy, Ethics, and Humanities in Medicine 13, no. 2. https://doi.org/10.1186/s13010-018-0055-2.

Zagzebski, Linda. 2012. Epistemic Authority: A Theory of Trust, Authority, and Autonomy in Belief. New York: Oxford University Press.

———. 2016. “Replies to Christoph Jäger and Elizabeth Fricker.” Episteme 13, no. 2: 187–94. https://doi.org/10.1017/epi.2015.39.




How to Cite

Popowicz, D. M. (2021). "Doctor Knows Best": On the Epistemic Authority of the Medical Practitioner. Philosophy of Medicine, 2(2). https://doi.org/10.5195/pom.2021.49



Original Research Articles (other)