General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms AbstractIn this paper we argue that ill persons can experience epistemic injustice in the sense articulated by Miranda Fricker (2007). Ill persons can suffer testimonial injustice through the presumptive attribution of characteristics like cognitive unreliability and emotional instability that downgrade the credibility of their testimonies. Ill persons can also suffer 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.

Oxford University Press, $50.00, 272 pp. ISBN 9780199669653 1 | INTRODUCTION Carel 0 s goal in Phenomenology of Illness is twofold: to use phenomenology to better understand illness and to highlight the value of illness to philosophy. The result is a book that is relevant to two very different readers: the clinician or health researcher, and the philosopher. I approach this review as a registered nurse and doctoral student, and, thus, my reading of the book is seen through a clinician researcher lens. Those familiar with the history of phenomenology are likely to argue that a phenomenological treatment of illness is not novel, which Carel herself highlights when distinguishing her work from that of Merleau-Ponty, Sartre, Toombs, Svenaeus, and others. 1(p36) She argues that these works have primarily focused on specific features of illness, as opposed to illness generally, whereas she seeks to develop a comprehensive phenomenology of illness. 1(p36) Carel states that an important part of this general framework is the ability to account for seemingly paradoxical phenomena such as traumatic growth wherein individuals report greater happiness after a brush with serious illness. 1(p38) Such a general framework is a worthy and valuable goal to both audiences of the text, and, in this effort, Carel largely succeeds. | SUMMARYCarel 0 s writing is a wonderful example of the power of the phenomenological approach. Phenomenology of Illness leaves the reader feeling a deeper appreciation for the experience of serious illness generally, and breathlessness specifically. Her use of quotes and stories is powerful and helps to highlight the effect of illness on lived time, space, body, and relation. An example of one such quote that highlights how illness affects our imagined future comes from Arthur Frank 0 s 2(p27) description of his cancer diagnosis: What was it like to be told I had cancer? The future disappeared. Loved ones became faces I would never see again. I felt I was walking through a nightmare that was unreal by utterly real. […] My body has become a kind of quicksand, and I was sinking into myself, into my disease. The text is rich with examples like this, both from Carel 0 s own experience and other published works. This approach is key in the book 0 s ability transform the abstract to the concrete. Carel restricts her efforts to "serious, chronic, and life-changing ill health, as opposed to a cold or bout of tonsillitis." 1(p6) The first chapter of the book summarizes the contributions to phenomenology of Husserl, Heidegger, Merleau-Ponty, and Sartre that are used through the book. This is a welcome piece of reading for those coming from a clinical background because it introduces concepts with admirable clarity. Carel develops her general framework in Chapters Two to Four and then applies it to the phenomenon of breathlessness in Chapter Five. The framework consists of a synthesis of Toomb 0 s five losses of illness 3 ; the objective body and the body as lived as introduced by Husserl and developed by Merleau-...

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This article analyses the phenomenon of epistemic injustice within contemporary healthcare. We begin by detailing the persistent complaints patients make about their testimonial frustration and hermeneutical marginalization, and the negative impact this has on their care. We offer an epistemic analysis of this problem using Miranda Fricker's account of epistemic injustice. We detail two types of epistemic injustice, testimonial and hermeneutical, and identify the negative stereotypes and structural features of modern healthcare practices that generate them. We claim that these stereotypes and structural features render ill persons especially vulnerable to these two types of epistemic injustice. We end by proposing five avenues for further work on epistemic injustice in healthcare.Without the narrative acts of telling and being heard, the patient cannot convey to anyone else -or to self -what he or she is going through. More radically and perhaps equally true, without these narrative acts, the patient cannot himself or herself grasp what the events of illness mean.

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