This article supports calls for an increased integration of patients into taxonomic decision making in psychiatry by arguing that their exclusion constitutes a special kind of epistemic injustice: preemptive testimonial injustice, which precludes the opportunity for testimony due to a wrongly presumed irrelevance or lack of expertise. Here, this presumption is misguided for two reasons: the role of values in psychiatric classification and the potential function of first-person knowledge as a corrective means against implicitly value-laden, inaccurate, or incomplete diagnostic criteria (...) sets. This kind of epistemic injustice leads to preventable epistemic losses in psychiatric classification, diagnosis, and treatment. (shrink)

Psychiatric classification, as exemplified by the Diagnostic and Statistical Manual of Mental Disorders, is dealing with a lack of trust and credibility—in the scientific, but also in the public realm. Regarding the latter in particular, one possible remedial measure for this crisis in trust lies in an increased integration of patients into the DSM revision process. The DSM, as a manual for clinical practice, is forced to make decisions that exceed available data and involve value-judgments. Regarding such decisions, public epistemic (...) trustworthiness requires that these value-judgments should be representative of those of the affected public, and that the public has a reason to believe such a representation to be realized. Due to the long tradition of distrust in psychiatry, such a reason can in this case best be provided by an actual integration of patients into the decision-making process, rather than by their representation through scientific experts. (shrink)

This article reports on the third phase of a comparative epistemological, ontological, and social analysis of a variety of approaches to investigating human behavior. In focusing on the fate of scientific ideas once they leave the context in which they were developed, I hope not only to show that their communication for a broader audience imposes a shape on their interrelations different than they seem to have in the research context, but also to suggest that a study comparing different approaches (...) to the same phenomenon is more illuminating than one that focuses on a single approach. (shrink)

Many successful sciences both serve and shape human ends. Conversely, the societies in which these sciences are practiced support the research and provide interpretive context. These mutual influences may result in a positive feedback loop that reinforces constitutive and contextual values, embedding them in scientific concepts: the ADHD concept is a case in point. In an ongoing process, social considerations fuel investigational choices and contexts for evaluating data. Scientific study forwards the feedback loop through the influence of investigative trends, by (...) directly and indirectly embedding values in data interpretation, and by core methodologies that heighten the contrast between ‘ADHD’ and ‘normal’. The resulting scientific conclusions embed value valences in the ADHD concept; social uptake of that valenced concept begins another round of interest in its implications and support of the science. The processes at work in the ADHD case are very general, so we should expect to see similar processes and results in other fields. (shrink)