Fricker shows that virtue epistemology provides a general epistemological idiom in which these issues can be forcefully discussed.

Miranda Fricker's book Epistemic Injustice is an original and stimulating contribution to contemporary epistemology. Fricker's main aim is to illustrate the ethical aspects of two of our basic epistemic practices, namely conveying knowledge to others and making sense of our own social experiences. In particular, she wishes to investigate the idea that there are prevalent and distinctively epistemic forms of injustice related to these aspects of our epistemic lives, injustices which reflect the fact that our actual epistemic practices are socially (...) situated. Most of the book focuses on two such forms – Testimonial Injustice and Hermeneutical Injustice – and on the epistemic virtues required to counteract them.Testimonial Injustice occurs when a hearer fails, because of prejudice, to give due credit to the word of a speaker. For instance, in the novel To Kill a Mockingbird, the jury in the trial of Tom Robinson fail to regard his testimony as credible because he …. (shrink)

Prescription opioid abuse (POA) is an escalating clinical and public health problem. Physician worries about iatrogenic addiction and whether patients are ‘drug seeking’, ‘abusing’ and ‘diverting’ prescription opioids exist against a backdrop of professional and legal consequences of prescribing that have created a climate of distrust in chronic pain management. One attempt to circumvent these worries is the use of opioid contracts that outline conditions patients must agree to in order to receive opioids. Opioid contracts have received some scholarly attention, (...) with trust and trustworthiness identified as key values and virtues. However, few articles have provided a critical account of trust and trustworthiness in this context, particularly when there exists disagreement about their role in terms of enhancing or detracting from the patient–physician relationship. This paper argues that opioid contracts represent a misleading appeal to patient–physician trust. Assuming the patient is untrustworthy may wrongfully undermine the credibility of the patient's testimony, which may exacerbate certain vulnerabilities of the person in pain. However, misplaced trust in certain patients may render the physician vulnerable to the potential harms of POA. If patients distrust their physician, or feel distrusted by them, this may destabilise the therapeutic relationship and compromise care. A process of epistemic humility may help cultivate mutual patient–physician trust. Epistemic humility is a collaborative effort between physicians and patients that recognises the role of patients’ subjective knowledge in enhancing physicians’ self-understanding of their theoretical and practice frameworks, values and assumptions about the motivations of certain patients who report chronic pain. (shrink)