Concept Of Epistemic Injustice Research Articles

‘This is Still All about Love’: Practitioners’ Perspectives of Working with Family Carers Affected by the Harmful Behaviour of the Older Person for Whom They Care

Abstract This article explores a hidden and under-acknowledged dimension of caring in family life: when older people with care needs act in a harmful, abusive or violent way towards the family member(s) who cares for them. Thirty-eight health and social care professionals, working in the UK, took part in five focus groups to explore their experience of working with families in this situation. The group discussions were stimulated by vignettes developed from interviews with carers affected by harmful behaviour, and the data generated using this method were analysed using a thematic approach. There were two principal findings: (i) ‘carer harm’ is a serious and under-acknowledged problem, which practitioners have extensive experiential knowledge of and (ii) practitioners face considerable practical and ethical challenges working with affected families. Drawing on Miranda Fricker’s concept of epistemic injustice, we discuss how contemporary social, legal and policy systems can make it difficult for practitioners to identify and meet the needs of affected families. Finally, we explore the role of social workers—and the support they need as a professional group—to work alongside a ‘hidden’ group of families seeking to manage the intersection of care, harm and intimacy in later life.

Student-staff partnerships at work: epistemic confidence, research-engaged teaching and vocational learning in the transition to higher education

ABSTRACT This study adapted a participatory action research (PAR) approach as part of student-staff collaboration aimed at co-producing a research-engaged pedagogy to provide vocational students with access to curricular opportunities to develop their academic capabilities. This article focuses on the co-creation process between seven multidisciplinary higher education (HE) students at different stages in their studies and two academic support staff. The participants immersed themselves in a double-loop inquiry process, researching student perceptions of belonging in their institution to co-produce knowledge to develop a research-based pedagogy. Working with the concept of epistemic injustice, we consider how participation in the inquiry influenced the student participants’ sense of credibility as knowers and producers of knowledge. Attention is paid to how the cycle of shared reflection and adaptation inherent in the PAR approach re-characterised power relationships between staff and students. We discuss how moments of discomforting disequilibrium were catalytic in the redistribution of power across the group. We maintain that adapting a PAR approach aimed at contributing to the Scholarship of Teaching and Learning (SoTL), provides students with opportunities to develop their epistemic confidence. However, for this to happen, students and staff must be willing to work with disequilibrium which emerges as student-staff power dynamics are challenged.

Epistemic Justice and the Struggle for Critical Suicide Literacy

ABSTRACT The concept of suicide literacy is currently used to describe a perceived deficit in public knowledge about suicide that is directly related to specific health actions and outcomes. It thereby fulfils an important function in determining the way health education and communication are constructed as a problem in suicide prevention policy and practice. In this work, I examine the incongruities produced by operationalisation of the concept of suicide literacy and the way it preserves structural inequities in epistemic practice. Drawing on the concept of epistemic injustice, I contend that the routine social and material practices of suicide prevention education and communication aimed at advancing suicide literacy restrict certain testimonial and hermeneutical activities, resulting in the silencing of alternative interpretations and expressions of suicide. Because these practices prevent critical thinking, help maintain professional privilege and hide complicity with potentially harmful practices they are ethically and politically significant. The uptake of wide-ranging epistemic contributions must be paramount in order to connect multiple perspectives and build knowledge. In order to create a more democratic approach to suicide prevention education and communication that cultivates critical dialogue and promotes social and political agency and change, new ways of thinking about suicide literacy are required.

Female family carers' experiences of violent, abusive or harmful behaviour by the older person for whom they care: a case of epistemic injustice?

Family carers affected by violent, abusive or harmful behaviour by the older person for whom they care face social and epistemic challenges in developing and sharing knowledge about their experiences. These difficulties have contributed to a situation in which there is a paucity of evidence and public discourse about how we understand violence and harm instigated by people who have care needs or are 'vulnerable'. This paper reports the findings of a qualitative study that involved 12 in-depth interviews with female carers affected by violence, abuse or harm. The study was informed theoretically by Miranda Fricker's concept of epistemic injustice which was used as a framework for analysis. There were two principal findings: (1) Carers were sensitive to anticipatory stigma and loss of moral autonomy. As a result, they self-censured what they shared and, at times, were met with subtle but powerful processes of silencing. (2) Carers had limited linguistic and conceptual resources to explain the emotional and social aspects of the harm they experienced, exacerbated by implicit social norms about the 'private' and gendered nature of familial care. To conclude, we discuss the implications of these findings for sociological research and health and social care practice.

Justice in education and recognitive justice

This paper focuses on a topical issue - the idea of ‘justice in education’ – developed by Krassimir Stojanov, among other recent educational justice theorists. Justice in education has to ask ‘educational questions about education’, which means that educational justice theory should be capable of dealing with educational practices, and constellations that are asymmetrical interaction orders. This requires, from the perspective of a child, criteria to distinguish between justified and unjustified educative demands towards responsibility and autonomy. This paper analyses forms of recognition as a legitimate summons that enables the individual’s autonomy. It also analyses the illegitimate demands that emerge from Stojanov’s innovative idea to combine the forms of misrecognition with the concepts of epistemic injustice.
 The second chapter of this paper introduces the challenges related to the recognitive justice as justice in education. The examination of Dietrich Benner’s recent critique of recognition theory illuminates these challenges in two ways: first, it is shown that there can be something negatively experienced, but the result of productive disruptions that the educator need to produce, which are out of the scope of recognition theory. Second, the recognitive justice paradigm ignores elementary pedagogical conditions and requirements, ‘the pedagogical knowledge’ and its methods, and is therefore unable to fully grasp the legitimate educational authority. This paper concludes with a synthesis that finds the crucial elements from the recognition theory to justice in education and critically assessing Benner’s claims. Overall, the paper offers potential for further development in justice in education.

Epistemic struggles: The role of advocacy in promoting epistemic justice and rights in mental health

Advocacy for people using health and social care services is widely promoted but its theoretical foundation is under-developed and its impact poorly conceptualised. This paper explores the liberatory potential of independent advocacy, using Fricker's concept of ‘epistemic injustice’ as a framework. People experiencing mental distress are particularly vulnerable to epistemic injustices as a consequence of deeply embedded social stigma resulting in a priori assumptions of irrationality and unreliability such that their knowledge is often discounted or downgraded. The mental health service user/survivor movement is at the forefront of validating personal experience and narrative to secure a different ontological and epistemological basis for mental distress. A foundational strand of this is advocacy to enable people to give voice to their experience.The case of independent mental health advocacy (IMHA) services under mental health legislation in England, provides an opportunity to critically examine whether advocacy can promote epistemic justice as a result of the legally sanctioned encounter between clinical assessment and subjective experience, pivoting on judgements about risk. This paper draws on empirical data from a national evaluation of IMHA services, which included 90 individual interviews with people subject to detention and three focus groups with mental health service users. Fricker's concept of epistemic injustice is used as a lens to investigate how this type of advocacy might mitigate forms of epistemic injustice, and thereby promote greater social justice in mental health.The concept of epistemic injustice provides a valuable theoretical basis for understanding the worth of advocacy in addressing testimonial injustice as well as its relative weakness in overcoming hermeneutical injustice. The challenge of independent advocacy to the dominant discourse within mental health is considered and questions raised about the place of advocacy in modern democratic mental health systems.

Are ME/CFS Patient Organizations "Militant"? : Patient Protest in a Medical Controversy.

Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) is a contested illness category. This paper investigates the common claim that patients with ME/CFS-and by extension, ME/CFS patient organizations (POs)-exhibit "militant" social and political tendencies. The paper opens with a history of the protracted scientific disagreement over ME/CFS. We observe that ME/CFS POs, medical doctors, and medical researchers exhibit clear differences in opinion over how to conceptualize this illness. However, we identify a common trope in the discourse over ME/CFS: the claim of "militant" patient activism. Scrutinizing this charge, we find no compelling evidence that the vast majority of patients with ME/CFS, or the POs representing them, have adopted any such militant political policies or behaviours. Instead, we observe key strategic similarities between ME/CFS POs in the United Kingdom and the AIDs activist organizations of the mid-1980s in the United States which sought to engage scientists using the platform of public activism and via scientific publications. Finally, we explore the contours of disagreement between POs and the medical community by drawing on the concept of epistemic injustice. We find that widespread negative stereotyping of patients and the marginalization and exclusion of patient voices by medical authorities provides a better explanation for expressions of frustration among patients with ME/CFS.

Vulnerability of Individuals With Mental Disorders to Epistemic Injustice in Both Clinical and Social Domains

Many individuals who have mental disorders often report negative experiences of a distinctively epistemic sort, such as not being listened to, not being taken seriously, or not being considered credible because of their psychiatric conditions. In an attempt to articulate and interpret these reports we present Fricker’s concepts of epistemic injustice (Fricker, 2007, p. 1) and then focus on testimonial injustice and hermeneutic injustice as it applies to individuals with mental disorders. The clinical impact of these concepts on quality of care is discussed. Within the clinical domain, we contrast epistemic injustice with epistemic privilege and authority. We then argue that testimonial and hermeneutic injustices also affect individuals with mental disorders not only when communicating with their caregivers but also in the social context as they attempt to reintegrate into the general society and assume responsibilities as productive citizens. Following the trend of the movement of mental health care to the community, the testimonies of people with mental disorders should not be restricted to issues involving their own personal mental states.

Amoral, im/moral and dis/loyal: Children's moral status in child welfare.

This article is a discursive examination of children’s status as knowledgeable moral agents within the Swedish child welfare system and in the widely used assessment framework BBIC. Departing from Fricker’s concept of epistemic injustice, three discursive positions of children’s moral status are identified: amoral, im/moral and dis/loyal. The findings show the undoubtedly moral child as largely missing and children’s agency as diminished, deviant or rendered ambiguous. Epistemic injustice applies particularly to disadvantaged children with difficult experiences who run the risk of being othered, or positioned as reproducing or accommodating to the very same social problems they may be victimised by.

Epistemic injustice in healthcare encounters: evidence from chronic fatigue syndrome

Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) remains a controversial illness category. This paper surveys the state of knowledge and attitudes about this illness and proposes that epistemic concerns about...

Toward Epistemic Justice: A Critically Reflexive Examination of ‘Sanism’ and Implications for Knowledge Generation

The dominance of medicalized “psy” discourses in the West has marginalized alternative perspectives and analyses of madness, resulting in the under-inclusion (or exclusion) from mainstream discourse of the firsthand experiences and perspectives of those who identify as Mad. We argue that this marginalization of firsthand knowledge(s) demands closer critical scrutiny, particularly through the use of critical reflexivity. This paper draws on Fricker’s concept of epistemic injustice, whereby a person is wronged in his or her capacity as a knower, as a useful framework for interrogating the subjugation of Mad knowledge(s). Also examined is the problem of sanism, a deeply embedded system of discrimination and oppression, as an underlying component of epistemic injustice. Sanism assumes a pathological view of madness, which can be attributed to what Rimke has termed psychocentrism: the notion that pathologies are rooted in the mind and/or body of the individual, rather than the product of social structures, relations, and problems. The paper examines how sanism marginalizes the knowledge(s) of Mad persons and contributes to epistemic injustice, and considers possibilities for advancing social justice using Mad epistemological perspectives

Wronged beyond words

In this article, I discuss cases in which moral grievances, particularly assertions that a moral injury has taken place, are systematically obstructed by received linguistic and epistemic practices. I suggest a social epistemological model for theorizing such cases of moral epistemic injustice. Towards this end, I offer a reconstruction of Lyotard’s concept of the differend, comparing it with Miranda Fricker’s concept of epistemic injustice, and considering it in light of some criticisms posed by Axel Honneth. Through this reconstruction and a series of examples, I demonstrate that a basic formal structure recurs in cases of discursively repressed moral injury, namely, a particular kind of dilemma. I argue that appreciating this dilemma pushes us in the direction of a form of non-ideal ethical theory and I conclude by elaborating a conception of moral reflective judgement that begins from particular experiences of moral injury and moves towards the creation of new moral universals.

Two Concepts of Epistemic Injustice

ABSTRACTI describe two concepts of epistemic injustice. The first of these concepts is explained through a critique of Alvin Goldman's veritistic social epistemology. The second is closely based on Miranda Fricker's concept of epistemic injustice. I argue that there is a tension between these two forms of epistemic injustice and tentatively suggest some ways of resolving the tension.