A lively topic of debate in decision theory over recent years concerns our understanding of the different risk attitudes exhibited by decision makers. There is ample evidence that risk-averse and risk-seeking behaviours are widespread, and a growing consensus that such behaviour is rationally permissible. In the context of clinical medicine, this matter is complicated by the fact that healthcare professionals must often make choices for the benefit of their patients, but the norms of rational choice are conventionally grounded in a (...) decision maker’s own desires, beliefs and actions. The presence of both doctor and patient raises the question of whose risk attitude matters for the choice at hand and what to do when these diverge. Must doctors make risky choices when treating risk-seeking patients? Ought they to be risk averse in general when choosing on behalf of others? In this paper, I will argue that healthcare professionals ought to adopt a deferential approach, whereby it is the risk attitude of the patient that matters in medical decision making. I will show how familiar arguments for widely held anti-paternalistic views about medicine can be straightforwardly extended to include not only patients’ evaluations of possible health states, but also their attitudes to risk. However, I will also show that this deferential view needs further refinement: patients’ higher-order attitudes towards their risk attitudes must be considered in order to avoid some counterexamples and to accommodate different views about what sort of attitudes risk attitudes actually are. (shrink)

Journal of Political Philosophy, Volume 30, Issue 3, Page 370-394, September 2022.

We present experimental evidence that supports the thesis :602–625, 2015, Br J Philos Sci 70:77–102, 2019; Bradley in Decisions theory with a human face, Cambridge University Press, Cambridge, 2017; Goldschmidt and Nissan-Rozen in Synthese 198:7553–7575, 2021) that people might positively or negatively desire risky prospects conditional on only some of the prospects’ outcomes obtaining. We argue that this evidence has important normative implications for the central debate in normative decision theory between two general approaches on how to rationalize several common (...) patterns of preference, which are ruled out as irrational by orthodox decision theory, namely the re-individuation approach and the non-expected utility approach. (shrink)