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Epistemic injustice in healthcare encounters: evidence from chronic fatigue syndrome

Kati

Kati

Patient in training
Messages
5,497
This:
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Source: http://blogs.bmj.com/medical-ethics...in-the-treatment-of-chronic-fatigue-syndrome/

Couldn't say it better.
 
G

ghosalb

Senior Member
Messages
136
Location
upstate NY
For most of us, this encounter injustice is as painful as the decease itself. Therefore, we patients/advocates should ask NIH to fix this problem first. Only NIH is able to do this by contacting as many doctors as possible. This does not need expensive research, scientists etc. Not a single non-CFS doctor I spoke to since NIH announcement were aware of the fact that it is a real decease and NIH is taking it seriously.
 
Jenny TipsforME

Jenny TipsforME

Senior Member
Messages
1,184
Location
Bristol
T

Tom Kindlon

Senior Member
Messages
1,734
An interesting concept:
Testimonial injustice

Fricker proposes that testimonial injustice occurs when a speaker is unfairly accorded a lower level of credibility as a result of prejudice—centrally, prejudice concerning their membership of a negatively stereotyped group. In such circumstances, a listener (implicitly and/or explicitly) interprets the speaker to have a diminished capacity qua testifier and bearer of knowledge (eg, they may view the speaker as untrustworthy or unreliable due to prejudice). The result is that the speaker’s contribution to the shared epistemic enterprise is unjustly excluded, dismissed or relegated to a lower status as a result of negative stereotyping associated with some of the speaker’s characteristics (eg, race, accent, age, gender, disability).
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Fricker claims that the individual suffers an epistemic insult or injustice, and that since the discrediting occurs in a social arena, the individual is also thereby dehumanised—degraded as a contributor of knowledge. She argues, “a speaker suffers testimonial injustice just if prejudice on the hearer’s part causes him to give the speaker less credibility than he would otherwise have given”.9
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A growing body of work has suggested that individuals suffering from ill health are more vulnerable to testimonial injustice, and this vulnerability exists across the different stages and epistemic practices of medical work.10 11 30–32
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Respect for multiple domains of knowledge ensures a collaborative working relationship in healthcare encounters.
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Injustice arises with respect to epistemic privilege when one group fails to recognise the unique expertise of another group, or when an individual fails to fully appreciate the epistemic contributions of another individual.
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T

Tom Kindlon

Senior Member
Messages
1,734
Similar to the last quote:
Marginalised groups may also be subject to ‘strategies of expression’ in which their particular forms of expression are taken as evidence of the group’s lack of rationality and lack of understanding of the modes of expression that are recognised as appropriate by the dominant group. Here, a form of expression that a marginalised group ‘uses in its efforts to make the case for the recognition of its hermeneutical resources can serve to undermine those very efforts. And this can lead to a vicious circle of increasing frustration, leading to more extreme styles of expression, which in turn lead to further epistemic disenfranchisement’. 11 p. 13.
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Tom Kindlon

Senior Member
Messages
1,734
This is explained more in the text:
The mobilisation of these two strategies results in an epistemic insult towards the speaker, who is not perceived as ‘fully rational’9 and imposes a double injury on the patient: the patient is marginalised for her testimony when that testimony involves a degree of inarticulacy. Patients are also excluded from engagement in the activities that would help enhance knowledge of their illness, and which could improve articulacy of the illness experience. In this way, hermeneutical injustice (exclusion from the structural processes of knowledge formation) may also intensify testimonial injustice and vice versa.
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Tom Kindlon

Senior Member
Messages
1,734
Surveys of GPs in the UK reveal a significant degree of scepticism about CFS/ME. In one survey, only half the respondents believed that CFS/ME was a real illness.37 This degree of scepticism towards the existence of the condition could lead to testimonial injustice because patient reports would not be seen to have a genuine medical cause. It could also lead to hermeneutical injustice because patient complaints may not be interpreted as cohering into a set of recognised symptoms, nor given meaning as clustering around CFS/ME.
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