This paper seeks to point the epistemic aspects of obstetric violence. In order to do so, we will introduce the concept of epistemic injustice, as developed by Miranda Fricker, and how it has been used by the social epistemology literature to think about health issues. Subsequently, we will examine reports of cases of obstetric violence as well as a case of forced sterilization, by reviewing the Final Report of the CPMI on the incidence of mass sterilization of women in Brazil, (...) as well as papers that describe cases of obstetric violence. Thus, we aim to point out that there is an epistemic aspect to such violations and that a change in the distribution of credibility may be relevant to confront obstetric violence. (shrink)

Recent philosophy has paid considerable attention to the way our biases are liable to encroach upon our cognitive lives, diminishing our capacity to know and unjustly denigrating the knowledge of others. The extent of the bias, and the range of domains to which it applies, has struck some as so great as to license talk of a new form of skepticism. I argue that these depressing consequences are real and, in some ways, even more intractable than has previously been recognized. (...) For the difficulties we face in this domain are fueled not only by implicit biases but by various other sorts of entrenched cognitive attitudes we bear toward others, whether or not we judge them to be our peers. Inasmuch as the epistemic standing of this broader set of attitudes is itself quite dubious, the problem of epistemic injustice turns out to be just one special case—albeit of a particularly nasty kind—from a broader domain of cases where the collaborative character of knowledge clashes with tendencies that make collaboration difficult. This makes the threat of skepticism all the greater, and at the same time makes it harder to see what path of escape there might be. (shrink)

Epistemic injustice has rapidly become a powerful tool for analysis of otherwise hidden social harms. Yet empirical research into how resistance to knowing and understanding can be generated and replicated in social programmes is limited. We have identified a range of subtle and not-so-subtle inflections of epistemic injustice as they play out in an intervention for people with chronic depression in receipt of disability benefits. This article describes the different ‘species’ of epistemic injustice observed and reveals how these are unintentionally (...) produced at frontline, management, commissioning and policy levels. Most notably, there remains a privileging of clinical knowledge over other forms of knowledge, producing a ‘pathocentric epistemic complex’. This, combined with the failure of different agencies with competing ideologies to adequately understand each other, and a vicious policy context, added to the injustices already faced by people with mental health issues, generating multiple harms. This has important implications for a range of integrated care and welfare interventions – not least by drawing attention to their unintended potential for replicating epistemic injustice as an institutionalised complex. Careful evaluation and design of such programmes, applying the philosophical and epistemic resources illustrated here, can help mitigate this outcome. Further, by raising awareness of epistemic injustice among programme participants, we can generate epistemic structures that secure programme integrity locally, and promote better policy. (shrink)

Type 1 diabetes (T1D) is a chronic illness that requires intensive lifelong management of blood glucose concentrations by means of external insulin administration. There have been substantial developments in the ways of measuring glucose levels, which is crucial to T1D self-management. Recently, continuous glucose monitoring (CGM) has allowed people with T1D to keep track of their blood glucose levels in near real-time. These devices have alarms that warn users about potentially dangerous blood glucose trends, which can often be shared with (...) ther people. CGM is consistently associated with improved glycemic control and reduced hypoglycemia and is currently recommended by doctors. However, due to the costs of CGM, only those who qualify for hospital provision or those who can personally afford it are able to use it, which excludes many people. In this paper, I argue that unequal access to CGM results in: (1) unjust health inequalities, (2) relational injustice, (3) injustice with regard to agency and autonomy, and (4) epistemic injustice. These considerations provide prima facie moral reasons why all people with T1D should have access to CGM technology. I discuss the specific case of CGM policy in the Netherlands, which currently only provides coverage for a small group of people with T1D, and argue that, especially with additional considerations of cost-effectiveness, the Dutch government ought to include CGM in basic health care insurance for all people with T1D. (shrink)

This article aims to provide a coherent and comprehensive theoretical framework of the main socio-epistemic features of social media. The first part consists of a concise discussion of the main epistemic consequences of personalised information filtering, with a focus on echo chambers and their many different implications. The middle section instead hosts an analytical investigation of the cognitive and epistemic environments of these platforms aimed at establishing whether, and to what extent, they allow their users to be epistemically vigilant with (...) respect to their sources and the content recommended to them. Finally, in the last part, of a more exquisitely normative nature, some strategies are proposed and discussed that, by reducing the epistemic opacity of social media, could contribute to greater epistemic justice within social media and, concurrently, to augmenting the epistemic autonomy of users. (shrink)

While much ink has been spilt over the political importance of speech, much less has been dedicated to the political importance of silence. This article seeks to fill that gap. We propose the need for a robust, democratic right to silence in public life and argue that there are politically salient epistemic reasons for recognising that right. We begin by defining what silence is and what a robust right to silence entails. We then argue that the right to silence offers (...) two politically salient epistemic benefits. The first is that, if the right to silence is maintained, we can avoid the epistemic harm that may be caused when an individual is compelled to lie in public. The second is that the right to silence can protect marginalised individuals against the epistemic injustices that may arise when others are likely to misconstrue their speech. (shrink)

In this paper, I show that there is a bidirectional relationship between gender-based social norms and gender-segregated education policies that excludes girls from knowledge production within the Iranian school system. I argue that gender segregation in education reproduces hermeneutic inequality through the reinforcement of epistemic segregation as a form of epistemic injustice. In particular, I focus on gender-based instructional epistemic injustice, which refers to a set of epistemic practices that actively exclude a student or an education professional in their capacity (...) as a knower from the process of knowledge production within an education system based on gender dynamics, roles, norms, or expectations. This, in addition, has an impact on schoolboys through the reproduction of active ignorance. I conclude that in societies such as Iran, where highly gendered norms play out in the school system and are further reinforced by that system, the result is not limited to gender segregation itself, but extends beyond it to a form of epistemic injustice that wrongs students by reproducing and reinforcing those highly gendered norms. (shrink)

Artificial intelligence (AI) and machine learning (ML) systems increasingly purport to deliver knowledge about people and the world. Unfortunately, they also seem to frequently present results that repeat or magnify biased treatment of racial and other vulnerable minorities. This paper proposes that at least some of the problems with AI’s treatment of minorities can be captured by the concept of epistemic injustice. To substantiate this claim, I argue that (1) pretrial detention and physiognomic AI systems commit testimonial injustice because their (...) target variables reflect inaccurate and unjust proxies for what they claim to measure; (2) classification systems, such as facial recognition, commit hermeneutic injustice because their classification taxonomies, almost no matter how they are derived, reflect and perpetuate racial and other stereotypes; and (3) epistemic injustice better explains what is going wrong in these types of situations than does the more common focus on procedural (un)fairness. (shrink)

This paper offers an overview of the philosophical work on epistemic injustices as it relates to psychiatry. After describing the development of epistemic injustice studies, we survey the existing literature on its application to psychiatry. We describe how the concept of epistemic injustice has been taken up into a range of debates in philosophy of psychiatry, including the nature of psychiatric conditions, psychiatric practices and research, and ameliorative projects. The final section of the paper indicates future directions for philosophical research (...) of epistemic injustices and psychiatry, concerning neurocognitive disorders, identity prejudices in psychiatric illness, concepts of epistemic privilege in psychiatry, and the prospects for combining phenomenological psychopathology and epistemic justice. We argue that much remains to be done in the conceptualization of these epistemic injustices and suggest that this future work should be multidisciplinary in character and sensitive to the phenomenology of psychiatric conditions. (shrink)

We analyse insufficient epistemic pluralism and associated problems in science-based policy advice during the COVID-19 pandemic drawing on specific arguments in Paul Feyerabend’s philosophy. Our goal is twofold: to deepen our understanding of the epistemic shortcomings in science-based policy during the pandemic, and to assess the merits and problems of Feyerabend’s arguments for epistemic pluralism as well as their relevance for policy-making. We discuss opportunities and challenges of integrating a plurality of viewpoints from within and outside science into policy advice (...) thus contributing to discussions about normative issues concerning evidence and expertise in policy-making. (shrink)

In this article, I apply the concept of solidarity to collective knowledge practices in healthcare. Generally, solidarity acknowledges that people are dependent on each other in many respects, and it captures those support practices that people engage in out of concern for others in whom they recognise a relevant similarity. Drawing on the rich literature on solidarity in bioethics and beyond, this article specifically discusses the role that epistemic solidarity can play in healthcare. It thus focuses, in particular, on solidarity’s (...) relationship with justice and injustice. In this regard, it is argued (1) that justice and solidarity are two equally important and complementary values that should both be considered in healthcare practices and institutions and (2) that solidarity often arises in unjust situations and can be a means to bring about justice. I transfer these ‘general’ insights about solidarity to knowledge practices in healthcare and link them to the discussion about epistemic injustices in healthcare and how to overcome them. I argue that epistemic solidarity can play an important role in overcoming epistemic injustices as well as—and independently from its contribution to justice—in knowledge production in medicine more generally. To demonstrate how epistemic solidarity can add to our understanding of collective knowledge practices, I discuss two examples: patients sharing their medical data for research purposes and healthcare professionals’ engagement with patients to better understand their afflictions. (shrink)

As it has historically been the case with many pandemics, the Covid-19 experience will induce many philosophers to reconsider the value of medical practice. This should be a good opportunity to critically scrutinize the way medical research and medical interventions are carried out. For much of its history, medicine has been very inefficient. But, even in its contemporary forms, a review of common protocols in medical research and medical interventions reveal many shortcomings, especially related to methodological flaws, and more importantly, (...) conflicts of interests due to profit incentives. In the face of these problems, we propose a program of “gentle medicine”. This term, originally formulated by philosopher Jacob Stegenga, describes a form of medicine in which physicians intervene less than they currently do. As part of this general program, we advance a series of reform recommendations that could be enacted both by medical staff in their everyday practice, but also by public health officials and policymakers. (shrink)

This article develops an account of distributive epistemic justice in the production of scientific knowledge. We identify four requirements: (a) science should produce the knowledge citizens need in order to reason about the common good, their individual good and pursuit thereof; (b) science should produce the knowledge those serving the public need to pursue justice effectively; (c) science should be organized in such a way that it does not aid the wilful manufacturing of ignorance; and (d) when making decisions about (...) epistemic risks, scientists should make sure that there aren’t social groups or weighty interests that are neglected. After discussing these requirements, we examine the relationship between discriminatory and distributive epistemic injustice in science and argue that they often compound each other. (shrink)

People with mental illnesses have higher prevalence and mortality rates with regard to common somatic diseases and causes of death, such as cardio-vascular conditions or cancer. One factor contributing to this excess morbidity and mortality is the sub-standard level of physical healthcare offered to the mentally ill. In particular, they are often subject to diagnostic overshadowing: a tendency to attribute physical symptoms to a pre-existing diagnosis of mental illness. This might be seen as an unfortunate instance of epistemic bad luck, (...) where particular features of a group of patients make a timely and correct diagnosis unlikely. While this can explain some cases of diagnostic overshadowing, I argue that in other cases, epistemic injustice is involved. Analyzing the case of diagnostic overshadowing, I distinguish two kinds of testimonial injustice. For one, there are classic cases of transactional testimonial injustice resulting from prejudices against the mentally ill. In addition, there are cases of structural testimonial injustice resulting from features of health care systems. To overcome diagnostic overshadowing, remedies on the individual as well as structural level are thus needed. (shrink)

Journal of Social Philosophy, EarlyView.

In her account of scientific objectivity, feminist philosopher of science Helen Longino shows how scientific objectivity is not so much of individual practice, but rather a social commitment practiced by a scientific community, provided by the necessary accommodations for critical discourse. However, is this conception of scientific objectivity truly capable of living up to the social realities of critical discourse and deliberation within a scientific community? Drawing from Dutilh Novaes’ social epistemological account of argumentation, this paper highlights the challenges Longino’s (...) scientific objectivity faces on a prescriptive and descriptive level, specifically in overcoming the various epistemic injustices Longino’s proposed structural accommodations for objectivity are still sensitive to. Dutilh Novaes’ social epistemological model of argumentation illustrates how the realities of critical debate too often don’t consist of true epistemic or knowledge exchange, even though such exchanges are essential to achieve Longino’s primary goal when redefining scientific objectivity: to wield out and address idiosyncratic background assumptions and individual bigotry that possibly influence a researcher’s scientific conduct. (shrink)

The concepts of disease, illness and sickness capture fundamentally different aspects of phenomena related to human ailments and healthcare. The philosophy and theory of medicine are making manifold efforts to capture the essence and normative implications of these concepts. In parallel, socio-empirical studies on patients’ understanding of their situation have yielded a comprehensive body of knowledge regarding subjective perspectives on health-related statuses. Although both scientific fields provide varied valuable insights, they have not been strongly linked to each other. Therefore, the (...) article aims to scrutinise the normative-ethical implications of patient perspectives in building a bridge to the empirical ethics debates. Three potential fields of tension between the illness and the disease perspective are presented. Consequently, findings from empirical research examining patient perspectives on illness are displayed and the practical implications and associated ethical issues which arise are discussed. This leads to the conclusion that an explicit and elaborate empirical-ethical methodology is needed to deal appropriately with the complex interaction between patients’ views and the medico-professional view of disease. Kon’s four-stage model of normative-empirical collaboration is then applied against the background of empirical data on patient perceptions. Starting from this exemplary approach, the article suggests employing empirical-ethical frameworks for further research on the conceptual and normative issues, as they help to integrate perspectives from the philosophy of medicine with socio-empirical research. The combination of theoretical and empirical perspectives suggested contributes to a more nuanced discussion of the normative impact of patients’ actual understanding of illness. Further empirical research in this area would profit from explicitly considering potential ethical issues to avoid naturalistic fallacies or crypto-normative conclusions that may compromise healthcare practice. Vice versa, medico-theoretical debates could be enriched by integrating subjective views of those people who are immediately affected. (shrink)

Although there is now a substantial body of literature exploring the effects of language diversity in international management contexts, little attention has been paid to the ethical dimensions of language diversity at work. This conceptual paper draws on the concept of epistemic injustice in order to explore how language, and in particular corporate language policies, may act as a source of epistemic injustice within the workplace. It demonstrates how language competence affects credibility judgements about a speaker, and also considers how (...) corporate language policies can create situations of hermeneutic injustice, in which marginalised groups are denied the vocabularies to understand their own experiences. Finally, ways in which such epistemic harms can be reduced are discussed, and the possibilities for management education to create epistemically responsible managers are highlighted. (shrink)

Journal of Social Philosophy, EarlyView.

In this paper, I take issue with the idea that Michel Foucault might be considered a theorist of epistemic injustice, and argue that his philosophical premises are incompatible with Miranda Fricker’s. Their main disagreement rests upon their divergent ways of conceiving the relationship between reason and power, giving rise to the contrasting forms of normativity that characterize their critical projects. This disagreement can be helpfully clarified by addressing the different use they make of the genealogical method. While Fricker’s genealogy of (...) Testimonial Justice aims to ground her claim that reason and power can be neatly pulled apart, thus avoiding the reductionist and relativist conclusions entailed by Foucault’s genealogies, I argue that Foucault’s mature, overlooked definition of genealogy is based on a sophisticated distinction between games and regimes of truth, and is thus not vulnerable to these criticisms. Consequently, Foucault’s genealogical inquiries prove helpful for understanding issues that normally fall under the umbrella of epistemic injustice in a new light, while also allowing us to avoid some of the main objections that threaten Fricker’s project. (shrink)

En matière de liberté d’expression, les normes de forme sont celles, sociales ou juridiques, qui, sans égard au contenu du discours, encadrent les moyens employés pour se faire entendre. L’analyse partira d’un cas spécifique de violation de ces normes : les actes expressifs illégaux, infractions que leurs auteurs présentent comme un exercice de leur liberté d’expression, quoiqu’ils enfreignent la légalité. Que ces infractions soient le plus souvent le fait de voix minoritaires conduit à examiner le lien entre normes de forme (...) et asymétries de pouvoir entre locuteurs sur le « marché des idées », et à proposer un assouplissement des normes de forme au bénéfice des discours minoritaires, tout en soulignant les difficultés de sa mise en œuvre juridique. (shrink)

Miranda Fricker’s influential concept of epistemic injustice has recently seen application to many areas of interest, with an increasing body of healthcare research using the concept of epistemic injustice in order to develop both general frameworks and accounts of specific medical conditions and patient groups. This paper illuminates tensions that arise between taking steps to protect against committing epistemic injustice in healthcare, and taking steps to understand the complexity of one’s predicament and treat it accordingly. Work on epistemic injustice is (...) therefore at risk of obfuscating legitimate and potentially fruitful inquiry. This paper uses Chronic Fatigue Syndrome/Myalgic Encephalomyelitis as a case study, but I suggest that the key problems identified could apply to other cases within healthcare, such as those classed as Medically Unexplained Illnesses, Functional Neurological Disorders and Psychiatric Disorders. Future work on epistemic injustice in healthcare must recognise and attend to this tension to protect against unsatisfactory attempts to correct epistemic injustice. (shrink)

This dissertation offers a robust philosophical examination of a phenomenon that is morally, socially, and politically significant – microaggressions. Microaggressions are understood to be brief and routine verbal, behavioral, or environmental indignities that, whether intentional or unintentional, convey hostility toward or bias against members of marginalized groups. Microaggressions are rooted in stereotypes and/or bias (whether implicit or explicit) and are connected to broader systems of oppression. Microaggressions are philosophically interesting, since they involve significant ambiguity, questions about speech and communication, and (...) the ability for our speech to encode and transmit bits of meaning. Microaggressions prompt reflection about the nature of blameworthiness and responsibility, especially for unintended acts and harms. They involve questions about how we perceive and treat one another, and whether or not people are treated as true equals in our social and political worlds. For all of these reasons, microaggressions are a critical area in need of philosophical reflection, specifically reflection in feminist philosophy, philosophy of language, moral philosophy, and social and political philosophy. This dissertation seeks to advance the philosophy of microaggressions through three distinct aims: a conceptual aim (chapters 2 and 3), an epistemological aim (chapters 1 and 2), and a moral aim (chapters 4 and 5). The conceptual aim involves clarifying how we should understand and categorize microaggressions. The epistemological aim involves identifying some of the epistemological assumptions undergirding discussions of microaggressions in the literature, including assumptions made by critics of microaggression theory, and arguing for an alternative epistemological framework for theorizing about microaggressions. The moral aim involves better understanding the harms of microaggressions, including their role in reinforcing structures of oppression and unjust social hierarchy. Taken together, these chapters make some progress on the conceptual, epistemological, and moral questions that microaggressions generate, and which philosophers have not yet adequately analyzed. It thus offers a meaningful contribution to the conversations philosophers are beginning to have about the morally and politically salient phenomenon of microaggressions. (shrink)

ABSTRACT It is a common contention that education done uncritically and unreflectively may serve to sustain and justify the status quo, in terms of mechanisms of cultural or racial privileging and marginalization. This article explores an argument made from within anti-oppressive education theory and advocated by theorist Kevin Kumashiro, namely that transformative education must entail altering harmful citational practices. I see two shortcomings in relation to this argument: first, its focus on discursive practice entails a prerequisite of high discursive literacy. (...) Second, it may lead to a failure to give credit to people’s intentions, risking a conflation of honest mistakes and wilful ignorance, and depriving us of theoretical nuance. While a well-argued and important call, I argue in this article that both shortcomings lead to the risk of a polarized conversation. Focusing on cultural, ethnic, and racial categorization, and using social studies as an illustration, it is suggested that applying notions from the theoretical concept of epistemic injustice may open up a space for granting nuanced credit to people’s intentions, thereby mitigating the risk of polarization. Rather than viewing attention to outcome and attention to intention as oppositional to one another, it is argued that both theoretical perspectives may benefit from the insights of the other. By applying needed context-specificity and nuance to categorizations of dominance and marginalization in individual discursive exchange, this can be done without granting priority to the experience of dominantly situated knowers. (shrink)