Willful Ignorance in the Context of Antibiotic Prescribing

Healthcare professionals tend to overprescribe antibiotics despite knowing the risks of antibiotic resistance. This tendency, amplified under diagnostic uncertainty and patient pressure, suggests that mechanisms beyond lack of risk awareness or knowledge sustain overprescription. One such mechanism may be willful ignorance—deliberately avoiding information about the consequences of one’s prescribing decisions. By allowing healthcare professionals to justify immediate antibiotic prescriptions that prioritize short-term self-interests over long-term collective benefits, willful ignorance may contribute to persistent overprescribing. Despite its practical relevance, this psychological mechanism has not yet been empirically investigated in the context of antibiotic prescribing. To test this empirically, we conducted a preregistered online experiment with healthcare professionals (N = 698) from the United States and the United Kingdom. Participants completed an adapted version of the Moral Wiggle Room Task, a behavioral decision-making paradigm designed to investigate willful ignorance. This task compares choices across a full information condition with low diagnostic uncertainty, and a hidden information condition with high diagnostic uncertainty that can be voluntarily reduced. The results support the presence of willful ignorance in antibiotic prescribing. Healthcare professionals were more likely to prescribe antibiotics immediately in the hidden vs. full information condition. Even healthcare professionals who voluntarily reduced diagnostic uncertainty prescribed more antibiotics immediately than those who received diagnostic information involuntarily. These results highlight the role of willful ignorance in antibiotic prescribing and suggest practical implications for policymaking, such as promoting transparent environments to guide appropriate antibiotic prescription choices.