Epistemic Microaggressions and Epistemic Harm in Medicine
29.04.24
2pm - 3:15pm
Drawing on her recently published book, Microaggressions in Medicine (Oxford 2024), this talk will provide an overview and analysis of epistemic microaggressions in medical contexts. Epistemic microaggressions result in epistemic harm to recipients. Focusing on cases of patients who are members of marginalized groups, the presentation will demonstrate how epistemic microaggressions can lead to a variety of serious short- and long-term harms to patients and therefore ought to be avoided by healthcare professionals. Special attention will be paid to the moral significance of epistemic microaggressions in medical contexts.
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Passcode: 668251
Epistemic Injustices and Mental Ill-Health
04.03.24
I will talk us through some types of epistemic injustice, principally: ‘testimonial injustice’, ‘pre-emptive testimonial injustice’, and ‘hermeneutical injustice’ which I defined in earlier work; and ‘testimonial smothering’ as defined by Kristie Dotson. I’ll explain these phenomena largely by way of examples from a memoir of mental ill-health written by the British actor David Harewood, Maybe I Don’t belong Here: A Memoir of Race, Identity, Breakdown and Recovery (2021). His personal story explores how experiences of racism, growing up in Britain in the seventies and as a young man in the eighties, sowed the seeds of personal fracture and psychological disconnect that later expressed themselves in psychosis.
I will also reflect that many psychiatrists and therapists effectively see their own work as including the amelioration of precisely these forms of epistemic injustice: aiming to create a therapeutic relationship in which credibility is not withheld, and shared intelligibility of experience is cultivated, with the result that the service-user may come to express themselves without needing to truncate or restyle what they want to say. This may be an impossible ideal, given that healthcare professionals must equally be diagnostically alert to fantasy, projection, and delusion, among other phenomena of epistemic disturbance, but impossible ideals can nonetheless be useful guiding ideals, playing a helpful informal self-regulatory role in one’s professional practice. If so, then perhaps the explicitly epistemic framing of this particular guiding ideal may make for a useful tool in the therapeutic toolbox?
This project was generously funded by wellcome. Grant : [226603/Z/22/Z], 'EPIC: Epistemic Injustice in Health Care'.