Especially troublesome in this dispute is the status of the natural sciences, and this is where Hacking finds some of his most telling cases, from the conflict ...

This volume has its roots in two recent developments within mainstream analytic epistemology: a growing recognition over the past two or three decades of the active and social nature of our epistemic lives; and, more recently still, the increasing appreciation of the various ways in which the epistemic practices of individuals and societies can, and often do, go wrong. The theoretical analysis of these breakdowns in epistemic practice, along with the various harms and wrongs that follow as a consequence, constitutes (...) an approach to epistemology that we refer to as non-ideal epistemology. In this introductory chapter we introduce and contextualise the ten essays that comprise this volume, situating them within four broad sub-fields: vice epistemology, epistemic injustice, inter-personal epistemic practices, and applied epistemology. We also provide a brief overview of several other important growth areas in non-ideal epistemology. (shrink)

It is often claimed in parts of the psychiatric literature that neuroscientific research into the biological basis of mental disorder undermines dualism in the philosophy of mind. This paper shows that such a claim does not apply to all forms of dualism. Focusing on Kenneth Kendler’s discussion of the mind–body problem in biological psychiatry, I argue that such criticism of dualism often conflates the psychological and phenomenal concepts of the mental. Moreover, it fails to acknowledge that there are different varieties (...) of dualism, and so overlooks the important metaphysical insights of contemporary dualist philosophers. I argue that while the neuroscientific research underpinning biological psychiatry challenges the traditional dualism of René Descartes, it does not pose any problem for the more modern dualism of David Chalmers. It is possible to take seriously the scientific claims of biological psychiatry while holding that this latter form of dualism is true. This has implications for the positioning of the mind–body problem in psychiatry. While the “easy” problem of explaining psychological processes is relevant to the aims of biological psychiatry, psychiatrists need not worry about the “hard” problem of consciousness. (shrink)

Ill persons suffer from a variety of epistemically-inflected harms and wrongs. Many of these are interpretable as specific forms of what we dub pathocentric epistemic injustices, these being ones that target and track ill persons. We sketch the general forms of pathocentric testimonial and hermeneutical injustice, each of which are pervasive within the experiences of ill persons during their encounters in healthcare contexts and the social world. What’s epistemically unjust might not be only agents, communities and institutions, but the theoretical (...) conceptions of health that structure our responses to illness. Thus, we suggest that although such pathocentric epistemic injustices have a variety of interpersonal and structural causes, they are also sustained by a deeper naturalistic conception of the nature of illness. (shrink)

Chronic fatigue syndrome or myalgic encephalomyelitis remains a controversial illness category. This paper surveys the state of knowledge and attitudes about this illness and proposes that epistemic concerns about the testimonial credibility of patients can be articulated using Miranda Fricker’s concept of epistemic injustice. While there is consensus within mainstream medical guidelines that there is no known cause of CFS/ME, there is continued debate about how best to conceive of CFS/ME, including disagreement about how to interpret clinical studies of treatments. (...) Against this background, robust qualitative and quantitative research from a range of countries has found that many doctors display uncertainty about whether CFS/ME is real, which may result in delays in diagnosis and treatment for patients. Strikingly, qualitative research evinces that patients with CFS/ME often experience suspicion by health professionals, and many patients vocally oppose the effectiveness, and the conceptualization, of their illness as psychologically treatable. We address the intersection of these issues and healthcare ethics, and claim that this state of affairs can be explained as a case of epistemic injustice. We find evidence that healthcare consultations are fora where patients with CFS/ME may be particularly vulnerable to epistemic injustice. We argue that the marginalization of many patients is a professional failure that may lead to further ethical and practical consequences both for progressive research into CFS/ME, and for ethical care and delivery of current treatments among individuals suffering from this debilitating illness. (shrink)

We survey several ways in which the structures and norms of medicine and healthcare can generate epistemic injustice.

In this paper we argue that ill persons are particularly vulnerable to epistemic injustice in the sense articulated by Fricker. Ill persons are vulnerable to testimonial injustice through the presumptive attribution of characteristics like cognitive unreliability and emotional instability that downgrade the credibility of their testimonies. Ill persons are also vulnerable to hermeneutical injustice because many aspects of the experience of illness are difficult to understand and communicate and this often owes to gaps in collective hermeneutical resources. We then argue (...) that epistemic injustice arises in part owing to the epistemic privilege enjoyed by the practitioners and institutions of contemporary healthcare services—the former owing to their training, expertise, and third-person psychology, and the latter owing to their implicit privileging of certain styles of articulating and evidencing testimonies in ways that marginalise ill persons. We suggest that a phenomenological toolkit may be part of an effort to ameliorate epistemic injustice. (shrink)

In the era of information and communication, issues of misinformation and miscommunication are more pressing than ever. _Epistemic injustice - _one of the most important and ground-breaking subjects to have emerged in philosophy in recent years - refers to those forms of unfair treatment that relate to issues of knowledge, understanding, and participation in communicative practices. The Routledge Handbook of Epistemic Injustice is an outstanding reference source to the key topics, problems and debates in this exciting subject. The first collection (...) of its kind, it comprises over thirty chapters by a team of international contributors, divided into five parts: Core Concepts Liberatory Epistemologies and Axes of Oppression Schools of Thought and Subfields within Epistemology Socio-political, Ethical, and Psychological Dimensions of Knowing Case Studies of Epistemic Injustice. As well as fundamental topics such as testimonial and hermeneutic injustice and epistemic trust, the Handbook includes chapters on important issues such as social and virtue epistemology, objectivity and objectification, implicit bias, and gender and race. Also included are chapters on areas in applied ethics and philosophy, such as law, education, and healthcare. The Routledge Handbook of Epistemic Injustice is essential reading for students and researchers in ethics, epistemology, political philosophy, feminist theory, and philosophy of race. It will also be very useful for those in related fields, such as cultural studies, sociology, education and law. (shrink)

Experiences of Depression is a philosophical exploration of what it is like to be depressed. In this important new book, Matthew Ratcliffe develops a detailed account of depression experiences by drawing on work in phenomenology, philosophy of mind and psychology, and several other disciplines.

Understood in their historical context, current debates about psychiatric classification, prompted by the publication of the DSM-5, open up new opportunities for improved translational research in psychiatry. In this paper, we draw lessons for translational research from three time slices of 20th century psychiatry. From the first time slice, 1913 and the publication of Jaspers’ General Psychopathology, the lesson is that translational research in psychiatry requires a pluralistic approach encompassing equally the sciences of mind (including the social sciences) and of (...) brain. From the second time slice, 1953 and a conference in New York from which our present symptom-based classifications are derived, the lesson is that, while reliability remains the basis of psychiatry as an observational science, validity too is essential to effective translation. From the third time slice, 1997 and a conference on psychiatric classification in Dallas that brought together patients and carers with researchers and clinicians, the lesson is that we need to build further on collaborative models of research combining expertise-by-training with expertise-by-experience. This is important if we are to meet the specific challenges to translation presented by the complexity of the concept of mental disorder, particularly as reflected in the diversity of desired treatment outcomes. Taken together, these three lessons – a pluralistic approach, reliability and validity, and closer collaboration – provide an emerging framework for more effective translation of research into practice in 21st century psychiatry. (shrink)

I shall first briefly revisit the broad idea of ‘epistemic injustice’, explaining how it can take either distributive or discriminatory form, in order to put the concepts of ‘testimonial injustice’ and ‘hermeneutical injustice’ in place. In previous work I have explored how the wrong of both kinds of epistemic injustice has both an ethical and an epistemic significance—someone is wronged in their capacity as a knower. But my present aim is to show that this wrong can also have a political (...) significance in relation to non-domination, and so to freedom. While it is only the republican conception of political freedom that presents nondomination as constitutive of freedom, I shall argue that non-domination is best understood as a thoroughly generic liberal ideal of freedom to which even negative libertarians are implicitly committed, for non-domination is negative liberty as of right—secured non-interference. Crucially on this conception, non-domination requires that the citizen can contest interferences. Pettit specifies three conditions of contestation, each of which protects against a salient risk of the would-be contester not getting a ‘proper hearing’. But I shall argue that missing from this list is anything to protect against a fourth salient threat: the threat that either kind of epistemic injustice might disable contestation by way of an unjust deflation of either credibility or intelligibility. Thus we see that both testimonial and hermeneutical injustice can render a would-be contester dominated. Epistemic justice is thereby revealed as a constitutive condition of non-domination, and thus of a central liberal political ideal of freedom. (shrink)