Comparing Critical Realism and the Situated Knowledges Approach in Research on (In)equity in Health Care: An Exploration of their Implications

Abstract

This article compares knowledge claims within critical realism and the situated knowledges approach, and will discuss the implications of adopting these two perspectives in research on inequity in health care. The concept of medical gender bias, as well as two empirical studies on inequity among patients waiting for cataract extractions in Sweden, will be used in order to illustrate the different implications of adopting a critical realist or a situated knowledges perspective. The article suggests that the latter of these two perspectives is compatible with critical realist claims about epistemic relativism, but that it is much harder to combine with the concept of judgmental rationality, at least in so far as this rationality is not treated as being situated itself. The article will also claim that critical realism and the situated knowledges approach emphasize different implications concerning responsibility during processes of knowledge production. Finally, it will suggest that the adoption of a critical realist-based intersectional ontology, in combination with a greater emphasis on the fact that researchers are always situated in various ways, is a fruitful starting point for grounding studies on inequity in health care.