What's True in Truth and Reconciliation? Why Epistemic Justice is of Paramount Importance in Addressing Structural Racism in Healthcare

Croce, Yoann Della; Gianni, Matteo; Marino, V. De

doi:10.1080/15265161.2020.1870764

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Since Carel and Kidd’s 2014 article dedicated to mapping the contours of epistemic injustice in healthcare settings (Carel and Kidd 2014 ), research on this issue has witnessed an impressive growth in the literature. Fricker’s conceptual apparatus has been used to explore and expose epistemic injustices in a wide variety of medical situations and subjects, including for instance psychiatry and mental illness (Lakeman 2010 ; Sanati and Kyratsous 2015 ; Kyratsous and Sanati 2016 ; Carver et al 2016 ; Crichton et al 2017 ; Scrutton 2017 ; Gosselin 2018 ; Newbigging and Ridley 2018 ; Miller Tate 2019 ; Bueter 2019 ; Drozdzowicz 2021 ), dementia (Spencer 2022), paediatrics (Harcourt 2021 ; Pham, Storch, and Lazara-Muñoz 2021 ), ableism and disability (Ho 2011 ; Scully 2018 ; Peña-Guzman and Reynolds 2019 ), medicalization (Wardrope 2014 ), self-injury (Sullivan 2019 ), chronic pain and fatigue syndromes (Buchman et al 2017 ; Blease et al 2017 ; Heggen and Berg 2021 ), macro allocations of resources (Gallagher et al 2021 ), and healthcare practice and patient empowerment at large (Carel and Kidd 2014 ; Kidd and Carel 2017 , 2018 ; Michaels 2021 ; Bogaert 2021 ; Blease et al 2021 ; Della Croce et al 2021 ; Pot 2022). Epistemic injustice has so far been used as a theoretical apparatus useful in describing and assessing real-world cases that occur in healthcare settings in order to highlight kinds of injustices that have previously been absent from ethical analysis.…”

Section: Introductionmentioning

confidence: 99%

Epistemic Injustice and Nonmaleficence

Croce

2023

Bioethical Inquiry

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Epistemic injustice has undergone a steady growth in the medical ethics literature throughout the last decade as many ethicists have found it to be a powerful tool for describing and assessing morally problematic situations in healthcare. However, surprisingly scarce attention has been devoted to how epistemic injustice relates to physicians’ professional duties on a conceptual level. I argue that epistemic injustice, specifically testimonial, collides with physicians’ duty of nonmaleficence and should thus be actively fought against in healthcare encounters on the ground of professional conduct. I do so by fleshing out how Fricker’s conception of testimonial injustice conflicts with the duty of nonmaleficence as defined in Beauchamp and Childress on theoretical grounds. From there, I argue that testimonial injustice produces two distinct types of harm, epistemic and non-epistemic. Epistemic harms are harms inflicted by the physician to the patient qua knower, whereas non-epistemic harms are inflicted to the patient qua patient. This latter case holds serious clinical implications and represent a failure of the process of due care on the part of the physician. I illustrate this through examples taken from the literature on fibromyalgia syndrome and show how testimonial injustice causes wrongful harm to patients, making it maleficent practice. Finally, I conclude on why nonmaleficence as a principle will not be normatively enough to fully address the problem of epistemic injustice in healthcare but nevertheless may serve as a good starting point in attempting to do so.

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Section: Introductionmentioning

confidence: 99%

Epistemic Injustice and Nonmaleficence

Croce

2023

Bioethical Inquiry

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confidence: 99%

“…Compared to the non-Indigenous population, Indigenous people experience higher rates of complications which may be related to the nature of injuries, decreased access to care, and complexity of care. 1,7 In Canada, there is a persistent narrative that Indigenous persons' lower standard of living and poor health is selfinflicted. 1 Many Canadians are working to unlearn negative perceptions of Indigenous persons through improved awareness of the legacy of assimilation, cultural genocide, residential schools, and overrepresentation in the child welfare system.…”

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confidence: 99%

“…1 Many Canadians are working to unlearn negative perceptions of Indigenous persons through improved awareness of the legacy of assimilation, cultural genocide, residential schools, and overrepresentation in the child welfare system. 7 Each encounter plastic surgeons have with Indigenous patients provides an opportunity to reflect upon their perceptions of Indigenous people and how it may impact patient care.…”

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confidence: 99%

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