This commentary offers a coherent reading of the papers presented in the special issue ‘Exclusion, Engagement, and Empathy: Reflections on Public Participation in Medicine and Technology’. Focusing on intellectual self-trust it adds a further perspective on the harmful epistemic consequences of social exclusion for individual agents in healthcare contexts. In addition to some clarifications regarding the concepts of ‘intellectual self-trust’ and ‘social exclusion’ the commentary also examines in what ways empathy, engagement and participatory sense-making could help to avoid threats to (...) intellectual self-trust that arise form being excluded from participation in communicative practices in the context of healthcare. (shrink)

With regard to organ donation, Germany is an ‘opt-in’ country, which requires explicit consent from donors. The relatives are either asked to decide on behalf of the donors’ preferences, if these are unknown or if the potential donor has explicitly transferred the decision to them. At the core of this policy lies the sociocultural and moral premise of a rational, autonomous individual, whose rights require legal protection in order to guarantee a voluntary decision. In concrete transplantation practices, the family plays (...) an even more important role. Potential donors and their families decide while being embedded in relations, a point which does still not gain full recognition. This particular discrepancy between policy and practice creates conflicts, which remain taboos of academic inquiry and public discourse. Our analysis shows a plurality of the family’s role in the transplantation process, which reveals an inner tension of the organ donation system. This tension provokes epistemic opacity on the one hand and different collective strategies as responses to discursive exclusion on the other. In future deliberations about organ donation, it is important to create spaces for open discussion, but also practices of communicative engagement, which take care of the needs and emotions attached to taboos. (shrink)

This paper examines epistemic injustice in knowledge production concerning autism. Its aim is to further our understanding of the distinctive shapes of the kinds of epistemic injustices against autists. The paper shows how Ian Hacking’s work on autistic autobiography brings into view a form of hermeneutical injustice that autists endure with respect to their firsthand accounts of their experiences of autism. It explores how understanding the distinctive shape of this hermeneutical injustice can help us further appreciate dangers and harms of (...) using interpretive frameworks for autistic experience that neglect autists’ own contributions to the formation of words and concepts for capturing their experiences. In particular, the paper argues that even when autists are included in knowledge production concerning autistic experience, they remain vulnerable to forms of hermeneutical marginalization that can stifle the coming into being of autistic experience. (shrink)