“Clinician Knows Best”? Injustices in the Medicalization of Mental Illness

Abstract

This paper uses a non-ideal theory approach advocated for by Alison Jaggar to show that practices involved with the medicalization of serious mental disorders can subject people who have these disorders to a cycle of vulnerability that keeps them trapped within systems of injustice. When medicalization locates mental disorders solely as problems of individual biology, without regard to social factors, and when it treats mental disorders as personal defects, it perpetuates injustice in several ways: by enabling biased diagnoses through stereotyping, by exploiting and coercing people who are seen as insufficiently competent, and by perpetuating idealized conceptions of choice and control that do not take into account people’s real limitations and the social context of health. Through practices of diagnosis, treatment, and recovery, medicalization can perpetuate injustices toward people who have serious mental disorders.

Epistemic injustices in clinical communication: the example of narrative elicitation in person‐centred care

“…Credibility has no distributive nature, that is the one is not believed ‘less’ because the other is believed ‘more’, yet it is crucial not to ‘ignore the role of credibility excesses for some people in producing credibility deficits in others’ (McKinnon 2016: 440) as these patterns of credibility are contextual and infused in the social imaginary. People with similar medical conditions may have different levels of credibility depending on wayward indicators, their abilities to express their symptoms and distress; some patient groups are often pushed to low levels of credibility such as mental health patients (Gosselin 2019), or those with medically unexplained symptoms (Werner and Malterud 2003).…”