Too often, identifying practices of silencing is a seemingly impossible exercise. Here I claim that attempting to give a conceptual reading of the epistemic violence present when silencing occurs can help distinguish the different ways members of oppressed groups are silenced with respect to testimony. I offer an account of epistemic violence as the failure, owing to pernicious ignorance, of hearers to meet the vulnerabilities of speakers in linguistic exchanges. Ultimately, I illustrate that by focusing on the ways in which (...) hearers fail to meet speaker dependency in a linguistic exchange, efforts can be made to demarcate the different types of silencing people face when attempting to testify from oppressed positions in society. (shrink)

Epistemic injustice is a harm done to a person in their capacity as an epistemic subject by undermining her capacity to engage in epistemic practices such as giving knowledge to others or making sense of one’s experiences. It has been argued that those who suffer from medical conditions are more vulnerable to epistemic injustice than the healthy. This paper claims that people with mental disorders are even more vulnerable to epistemic injustice than those with somatic illnesses. Two kinds of contributory (...) factors for epistemic injustice in psychiatric patients are outlined: global and specific. Some suggestions are made to counteract the effects of these contributory factors, for instance we suggest that physicians should participate in groups where the subjective experience of patients is explored, and learn to become more aware of their own unconscious prejudices towards psychiatric patients. (shrink)

This article argues that the Seven Solutions in the US, and the Research Excellence Framework in the UK, manifest the vice of epistemic insensibility. Section I provides an overview of Aristotle's analysis of moral vice in people. Section II applies Aristotle's analysis to epistemic vice, developing an account of epistemic insensibility. In so doing, it contributes a new epistemic vice to the field of virtue epistemology. Section III argues that the (US) Seven Breakthrough Solutions and, to a lesser extent, the (...) (UK) Research Excellence Framework manifest two key features of the vice of epistemic insensibility. First, they promote a failure to desire, consume, and enjoy some knowledge that it is appropriate to desire, consume, and enjoy. Second, they do so because they wrongly assume that such knowledge is not epistemically good. The Solutions wrongly assume that any research that lacks ‘impact’, in the form of funding, thereby lacks epistemic value. The REF wrongly assumes of otherwise comparable bodies of research, that the research that lacks ‘impact’ has less epistemic value. (shrink)

In Epistemic injustice, Miranda Fricker makes a tremendous contribution to theorizing the intersection of social epistemology with theories of justice. Theories of justice often take as their object of assessment either interpersonal transactions (specific exchanges between persons) or particular institutions. They may also take a more comprehensive perspective in assessing systems of institutions. This systemic perspective may enable control of the cumulative effects of millions of individual transactions that cannot be controlled at the individual or institutional levels. This is true (...) not only with respect to the overall distribution of such goods as income and wealth, but also with respect to the goods of testimonial and hermeneutical justice. Cognitive biases that may be difficult for even epistemically virtuous individuals to correct on their own may be more susceptible to correction if we focus on the principles that should govern our systems of testimonial gathering and assessment. Hence, while Fricker’s focus on individual epistemic virtue is important, we also need to consider what epistemic justice as a virtue of social systems would require. My paper will indicate some directions forward on this front, focusing on the need for integration of diverse institutions and persons engaged in inquiry. (shrink)

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

This paper examines some of the key characteristics of a socialist health care system using the example of the British National Health Service (NHS). It has been claimed that the NHS has socialist principles, and represents an island of socialism in a capitalist sea. However, using historical analysis, this paper argues that while the NHS claims some socialist ends, they could never be fully achieved because of the lack of socialist means. The socialist mechanisms which were associated with earlier plans (...) for a national health service such as a salaried service, health centres, elected health authorities and divorcing private practice from the public service were discarded in negotiation. Moreover, even these would have achieved socialism merely in the sense of distributing health care, without any deeper transformation associated with doctor-patient relationships and prevention. In short, the NHS is more correctly seen as nationalised rather than socialised medicine, achieving the first three levels of a socialist health service identified here. It can be said to have socialist principles in the limited distributional sense and has some socialist means to achieve these. However, it lacks the stronger means to fully achieve its distributional goals, and is very distant from the third level of a radical transformation of health care. (shrink)

Drawing on an analysis of complaint files that we conducted for the Irish Medical Council, this paper offers three possible explanations for the gap between the ubiquity of official commitments to taking patients’ complaints seriously and medical professional regulators’ dismissal—as not warranting an inquiry—of the vast majority of complaints submitted by members of the public. One explanation points to the “regulatory illiteracy” of many complainants, where the remit and threshold of seriousness of regulators is poorly understood by the general public. (...) Another points to possible processes of “institutional epistemic injustice” that unjustly undermine the credibility of certain complainants, such as those with low levels of formal education. A third explanation highlights the marginalization of the general public from “symbolic power” to define what matters in medical professional regulation. The paper is offered in a spirit of ideas in progress and raising questions rather than definitive insights into the regulatory process. (shrink)

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. (shrink)

In this article, I examine stigmatizing and especially patronizing attitudes towards others’ depression that people who are well-intentioned produce. The strategy of the article is to consider the social experience of depression through two separate subfields of philosophy: epistemic injustice and phenomenology. The solution that I propose is a phenomenological account of empathy. The empathetic attitude that I argue for involves actively listening to the depressed individual and taking their depression testimony as direct evidence. The article has been written both (...) for those who seek to better support neurodiverse people in their lives and for depressives (and other neurodivergents) themselves in order to provide them with a better account for advocating for themselves against social stigma. (shrink)

In this paper, we argue that certain theoretical conceptions of health, particularly those described as ‘biomedical’ or ‘naturalistic’, are viciously epistemically unjust. Drawing on some recent work in vice epistemology, we identity three ways that abstract objects (such as theoretical conceptions, doctrines, or stances) can be legitimately described as epistemically vicious. If this is right, then robust reform of individuals, social systems, and institutions would not be enough to secure epistemic justice: we must reform the deeper conceptions of health that (...) underlie them. (shrink)