This paper explores the consequences of applying two natural ideas from epistemology to decision theory: (1) that knowledge should guide our actions, and (2) that we know a lot of non-trivial things. In particular, we explore the consequences of these ideas as they are applied to standard decision theoretic puzzles such as the St. Petersburg Paradox. In doing so, we develop a “knowledge-first” decision theory and we will see how it can help us avoid fanaticism with regard to the St. (...) Petersburg puzzle and related puzzles. The result will be a decision theory that gives a novel, but well-motivated, reason for discounting small probabilities when making decisions. We examine the merits and demerits of such a decision theory. (shrink)