A Matter of Judgment? Second-Hand Medical Knowledge and Professional Responsibility

Professional judgment is of contested value today. Some argue that the current availability of tools for aligning decisions with evidence-based standards implies that individual judgment should be limited as much as possible. This article argues to the contrary: professional judgment remains a precondition for responsible practice. Nevertheless, increased epistemic dependence-the turn to second-hand medical knowledge-alters the domains of judgment. As first-order evidence has become overwhelming and opaque to practitioners, they need intelligent ways of placing their trust, of integrating different kinds of epistemic tools, and taking responsibility for consequences. The article suggests how these tasks can be seen as a complement to the original ambition of the evidence movement of promoting research literacy.