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 prescribing that prioritize short-term self-interests over long-term collective benefits, willful ignorance may contribute to persistent overprescribing. Despite its practical relevance, willful ignorance has not yet been investigated in the context of antibiotic prescribing. To test this empirically, we conducted two preregistered online experiments with healthcare professionals 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 diagnostic certainty, and a hidden information condition with diagnostic uncertainty that can be voluntarily reduced. In Experiment 1 (N = 698), healthcare professionals were more likely to prescribe antibiotics immediately in the hidden vs. full information condition, supporting the presence of willful ignorance. In Experiment 2 (N = 150), making the collective consequences of antibiotic prescribing for antibiotic resistance salient substantially reduced willful ignorance. These results highlight the role of willful ignorance in antibiotic prescribing and point to practical implications: promoting transparent environments and communicating the collective consequences of antibiotic use may help support more appropriate antibiotic prescribing decisions.