Dealing With Conflicts in Medical Decisions: Epistemic Reasonable Disagreement Between Parents and Medical Staff

Many controversies in medical ethics, particularly those involving conflicts between parents and medical staff over decisions about child patients, are challenging to manage without causing significant polarization and communication issues. This is primarily because the parties involved-parents and physicians-operate at different epistemic levels, engaging with and relying on distinct forms of knowledge. A key issue underlying this epistemic disparity-the imbalance in how each party's knowledge is recognized and valued-is the difficulty of achieving what I term epistemic reasonable disagreement. This concept is crucial for fostering a shared decision-making process in which parents and physicians recognize each other's equal epistemic value, acknowledging that both perspectives are equally credible and understandable. Establishing full credibility for the parental position can be problematic because it is typically grounded in emotions, a quality often undervalued in bioethics. This paper argues, however, that the tendency to dismiss emotions can be mitigated by applying the principle of charity. Achieving reasonable epistemic equality allows for the recognition of parents' epistemic contributions as a form of knowledge. Applying a framework for epistemic reasonable disagreement can prevent testimonial and hermeneutical injustice towards parents and encourage a re-evaluation of how dialogue between parents and physicians should be approached.