 We began by discussing a puzzle raised by higher-order evidence: it seems that agents in situations like Hypoxia should reduce confidence, but also that if they do, they will be ignoring evidence in a problematic way. We have seen some arguments against reducing confidence, and some proposals for how Aisha should reduce confidence. But some epistemologists think that neither of these possibilities gives us the full story. Maybe level-bridging principles are genuine rational requirements, but there is still something wrong with Aisha if she reduces confidence. Or maybe they are not genuine rational requirements, yet there is something else wrong with Aisha if she does not reduce confidence. Maybe they are both rational requirements, and Aisha is facing an epistemic dilemma. (An alternative way to frame the puzzle focuses on epistemic akrasia: maybe Aisha is rationally required to be epistemically akratic in her situation, but there is something else wrong with her if she is epistemically akratic, and so forth.)