Mapping out epistemic justice in the clinical space: using narrative techniques to affirm patients as knowers

Leah Teresa Rosen

doi:10.1186/s13010-021-00110-0

Abstract

Epistemic injustice sits at the intersection of ethics, epistemology, and social justice. Generally, this philosophical term describes when a person is wrongfully discredited as a knower; and within the clinical space, epistemic injustice is the underlying reason that some patient testimonies are valued above others. The following essay seeks to connect patterns of social prejudice to the clinical realm in the United States: illustrating how factors such as race, gender identity, and socioeconomic status influence epistemic credence and associatively, the quality of healthcare a person receives.After describing how epistemic injustice disproportionately harms already vulnerable patients, I propose a narrative therapy intervention. This intervention can help providers re-frame their relationships with patients, in such that they come to view patients as valuable sources of unique knowledge. Though I identify this intervention as a valuable step in addressing clinical epistemic injustice, I call upon medical educators and practitioners to further uplift the voices, perspectives, and stories of marginalized patients.

Highlights

Epistemic injustice sits at the intersection of ethics, epistemology, and social justice
While the aforementioned injustices are perpetrated on the basis of race, gender, and socioeconomic status respectively, epistemic injustice pertains to epistemology—the theory of
Because knowledge is so intertwined with power in the modern Western world, epistemic injustice has become a device of domestic sociopolitical oppression in the United States: serving to frame already powerful persons as legitimate knowers, and in turn, debase the testimonies offered by persons with less power or social capital

Summary

Introduction

Epistemic injustice sits at the intersection of ethics, epistemology, and social justice. The clinical realm reflects the injustices and inequalities that are present in US society, and can further reinforce these issues by treating patients differently depending on their identity traits.

Results

Conclusion