 RatRef gives a sensible account of cases like the underslept doctor. It would say the reason that the realization she is sleep-deprived should make her less confident of her diagnosis is that a maximally rational person in her situation would have a lower confidence. Moreover this provides us with a way of representing the state of self-doubt coherently, even with perfect knowledge of what one’s belief states are. One can have degree of belief y in q, and one can even believe that one has degree of belief y, that is, believe that \(P(q) = y\), consistently with believing that the maximally rational agent has degree of belief x, i.e., \(P_{M}(q) =x\), because these are two different probability functions.