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In this chapter, we discuss the relationship of individual personal thriving to fairness and worthiness by exploring the concept of epistemic injustice. Epistemic injustice refers to the rejection of people’s capacity as knowers, such that these individuals are treated as being less knowledgeable and less believable than other people, frequently on the basis of their social identities. In the first half of the chapter, we will explain how epistemic injustices take place and how they interrupt human thriving. In the second half of the chapter, we will profile the ways that psychologists and others can work to prevent epistemic injustice.
This article explores the implications of non-ideal theorising for the problem of evil. The critique of ideal theory – which has gained increased attention in several philosophical sub-disciplines during recent years – states that analytic philosophers tend to rely on overly idealised conditions, to the point of being completely unrealistic, in their theorising. To investigate if this charge holds merit in the philosophy of religion, I apply a non-ideal methodology to one traditional area of philosophy of religion – the problem of evil. Here, Richard Swinburne’s theodicy constitutes a sample of how the problem of evil is typically approached in mainstream philosophy of religion. Additionally, Swinburne’s Principle of Credulity will, in relation to his theodicy, be interrogated as well. Applying non-ideal theorising, I find that Swinburne’s theorisation relies on idealised cases and presupposes ideal conditions, while overlooking non-ideal realities. Turning to epistemic injustice and epistemology of ignorance, I find that Swinburne assumes ideal epistemological conditions in both inter-agent communication (testimony), and in collective cognition. After examining the implications of such idealisations, I find that Swinburne’s idealisations abstract away non-ideal factors which are relevant for his theories, concluding that Swinburne displays tendencies typical of ideal theorising.
Borderline personality disorder (BPD) has been a controversial diagnosis for over 40 years. It was to be removed from the latest version of the ICD, only to be reintroduced as a trait qualifier as a result of last-minute lobbying. Retaining BPD as a de facto diagnosis keeps us stuck at a deadlock that undermines the voices of patients who have persistently told us this label adds ‘insult to injury’. Miranda Fricker's concept of epistemic injustice helps illuminate how this affects subjectivity and speech, hermeneutically sealing patients in ways of thinking that are not evidence-based, resulting in testimonial smothering (altering or withholding one's narratives) and testimonial quieting (dismissing a speaker's capacity to provide worthy testimony) that prevent more affirmative explanations.
David Hume’s famous argument against believing miracle reports exemplifies several key issues relating to the emergence of modern naturalism. Hume uncritically assumes the universal and unproblematic nature of core conceptions such as ‘supernatural’ and ‘laws of nature’. Hume’s argument also presents him with a dilemma. He relies upon the weight of testimony to establish his case against believing miracle reports, but must also contend with the weight of testimony, across different times and cultures, to the existence of the supernatural. Hume resolves this by an appeal to historical progress accompanied by a dubious racial theory. These enable him to discount testimonies emanating from the past and from other cultures. ‘Hume’s dilemma’ has not gone away and, if anything, is even more acute since the traditions and beliefs of non-Western cultures are now more difficult to dismiss on the basis of dubious historical accounts of Western exceptionalism. This dilemma amounts to a tension between the ethics of belief and the demands of epistemic justice.
From music recommendation to assessment of asylum applications, machine-learning algorithms play a fundamental role in our lives. Naturally, the rise of AI implementation strategies has brought to public attention the ethical risks involved. However, the dominant anti-discrimination discourse, too often preoccupied with identifying particular instances of harmful AIs, has yet to bring clearly into focus the more structural roots of AI-based injustice. This paper addresses the problem of AI-based injustice from a distinctively epistemic angle. More precisely, I argue that the injustice generated by the implementation of AI machines in our societies is, in some paradigmatic cases, also a form of epistemic injustice. With a particular focus on AIs employed as gatekeepers of our epistemic resources, this paper shows how their epistemically conformist behaviour is responsible for the marginalisation and the ostracism of minoritarian perspectives. Because it clarifies key structural flaws and weaknesses of current AI design, this paper helps make headway in critical discussion of current AI technologies. And because it forges new theoretical tools to understand forms of epistemic oppression, this paper also contributes to the advancement of feminist theorisation.
This paper examines the relatively underexplored relationship between epistemic wrongs and epistemic harms in the context of epistemic injustice. Does the presence of one always imply the presence of the other? Or, is it possible to have one without the other? Here we aim to establish a prima facie case that epistemic wrongs do not always produce epistemic harms. We argue that the epistemic wrongness of an action should never be evaluated solely based on the action's consequences, viz. the epistemic and practical harms suffered by the wronged party. Instead – as we shall show – epistemic harms necessarily follow from epistemic wrongs. To conclude, we suggest ways in which extant accounts of epistemic wrongs and epistemic harms as they cash out in epistemic injustice contexts might be refined in light of our argument.
This paper focuses on how experiences of trauma can lead to generalized fear of people, objects and places that are similar or contextually or conceptually related to those that produced the initial fear, causing epistemic, affective and practical harms to those who are unduly feared and those who are intimates of the victim of trauma. We argue that cases of fear generalization that bring harm to other people constitute examples of injustice closely akin to testimonial injustice, specifically, mnemonic injustice. Mnemonic injustice is a label that has been introduced to capture how injustice can occur via the operation of human memory systems when stereotypes shape what is remembered. Here we argue that injustices can also occur via memory systems when trauma leads to a generalized fear. We also argue that this calls for a reformulation of the notion of mnemonic injustice.
Truth and Reconciliation Commissions (TRCs) have become a widely used tool to reconcile societies in the aftermath of widespread injustice or social and political conflict in a state. This article focuses on TRCs that take place in non-transitional societies in which the political and social structures, institutions, and power relations have largely remained in place since the time of injustice. Furthermore, it will focus on one particular injustice that TRCs try to address through the practice of truth-telling, namely the eradication of epistemic injustice. The article takes the Canadian and Norwegian TRCs as two examples to show that under conditions of enduring injustice, willful ignorance of the majority, and power inequality, TRCs might create a double bind for victims which makes them choose between epistemic exploitation and continued injustices based on the majority's ignorance. The article argues that the set-up and accompanying measures of TRCs are of the utmost importance if TRCs in non-transitional societies are to overcome epistemic injustice, instead of creating new relations of exploitation.
The philosophical underpinnings of primary care have been examined from several perspectives in recent years. In two previous articles, we have argued that a relational view of autonomy is better matched to the primary care setting than others, and that view is mainly formed from the descriptors of its practice. Here we develop that analysis further, linking it to other relevant theory: the experience of human suffering and epistemic injustice. We argue that relational care is fundamental to ameliorating epistemic injustice and that relationships are integral to ethical practice, rather than being distinct. We propose that personalised care as described in the NHS Long Term Plan is not possible without addressing epistemic injustice and therefore without reconsidering our existing normative ethical frameworks.
The author makes the case that wealth inequality ramifies in the communicative practices of policymaking in ways which produce specific forms of epistemic injustice. Relative epistemic authority between richer and poorer knowers is established by limiting some speakers to being sources of information, and elevating others to the epistemically more sophisticated role of inquirer. In its systemic form, this differentiation has the effect of re-producing and maintaining ‘tracker prejudices’ (Fricker, 2007) and ‘tracker privileges’ (Medina, 2011) which then ramify in relational and distributive inequality (Fricker, 2016). The article suggests that in a context in which the inclusion of ‘lived experience’ has come to be seen as an intrinsic good in policy discourse (Smith-Merry, 2020), the lived experience we need to amplify isn’t that of the poor, it is that of the rich. Only in centring rich voices in social policymaking can we reveal and challenge the operation of wealth privilege and advance reparatory forms of epistemic practice.1
Over the centuries, many philosophers have written about injustice. More recently, attention has turned to a previously little-recognized form of injustice – epistemic injustice. The philosopher Miranda Fricker coined the phrase ‘epistemic injustice’ – an example being when your credibility as a source of knowledge is unjustly downgraded (perhaps because you are ‘just a woman’ of the ‘wrong’ race). This interview with Miranda explores what epistemic injustice is, and why it is important.
Stories of great medical discoveries are littered with examples of individual brilliance. This paradigm, however, in which individual brilliance is the cornerstone of great breakthroughs, is probably outdated. Of late, evidence suggests that modern research excellence often stems from collaboration and teamwork. This chapter is concerned with how team size, gender composition, and the geographical backgrounds of team members influence the types of research projects that are pursued. It also discusses how we can create a more diverse workforce and combat demographic biases in funding. Finally, the end of the chapter is concerned with how diversifying the scientific workforce can improve the rate of discovery and steer the direction of discovery towards more socially-relevant areas of research.
This article uses three fictitious case vignettes to raise questions and educate on how clinicians can appropriately approach patients experiencing spiritually significant hallucinations. Religious hallucinations are common but are not pathognomonic of mental illness. They are often intimate experiences for the patient that raise complex questions about psychopathology for clinicians. When assessing a patient with religious hallucinations it is important that clinicians hold at the centre that person's personal experience and create a safe space in which they are listened to and epistemic injustices are avoided. Involvement of chaplaincy services is important not just to support the patient but also to ensure that as clinicians we seek support in understanding the religious nature of these experiences.
According to Miranda Fricker, being hindered from rendering something significant about oneself intelligible to someone constitutes a hermeneutical injustice only if it results from the hermeneutical marginalization of some group to which one belongs. A major problem for Fricker's picture is that it cannot properly account for the paradigm case of hermeneutical injustice Fricker herself takes from Ian McEwan's novel Enduring Love. In order to account properly for this case, I argue that being hindered from rendering something significant about oneself intelligible to someone can constitute a hermeneutical injustice so long as it results from the hermeneutical marginalization of some group – whether or not one belongs to that group. One upshot is that Fricker's distinction between systematic and incidental cases of hermeneutical injustice needs redrawing, and I show how this can be done. Another is that hermeneutical injustice is more widespread than Fricker recognizes.
Chapter 4 considers power as essential to understanding who is legally liable and who is socially and politically responsible, for addressing historical-structural injustices. The chapter outlines competing conceptions of power, preferring and applying political scientist Mark Haugaard’s four-dimensional conception of power to address the complexities of historical-structural injustices, namely power as agency, structure, epistemic, and ontological power. The chapter then examines the role of national and religious myths as justification narratives that maintain existing distributions and structures of power and construct limitations in addressing the past in transitional justice. As a result, it argues that changes in the distribution of power are central to addressing historical-structural injustices, which have coalesced to form national and religious myths that support the existing distributions of power and modern national and religious identities.
What is the value of including vulnerable people in risk regulation decision-making in the European Union (EU)? This article examines a distinctive approach employed by the European Medicines Agency (EMA): public hearings integrated within safety reviews of medicinal products. The article presents findings from a case study of the EMA’s public hearing on Quinolone antibiotics, which was included by the EMA as part of a review process that led to significant tightening of regulatory restrictions on the prescribing of this class of antibiotics. The article argues that the public hearing enabled a group of patients who had been victims of a debilitating toxicity syndrome associated with Quinolone antibiotics to criticise the existing scientific evidence base around the safety of Quinolone. Deploying the quantitative Discourse Quality Index and an interpretive analytical approach, the article shows how patients challenged the evidence base in a manner that was efficacious in advancing knowledge in this area of risk regulation. When physically staged alongside interventions by professional experts, the article argues that patients facilitated a process of “negotiation” of expertise, leading professional representatives to propose methods of coordination in order to integrate the patients’ qualitative evidence of their suffering with the toxicity syndrome. Ultimately, this process led to the EMA proposing more stringent future guidelines for the prescription of Quinolone antibiotics in the EU.
When J.R. Cash (Johnny Cash) sings that he shot a man in Reno just to watch him die, audiences impressed by the singer's skillful creation and depiction of a nihilistic lyrical subject clap and cheer. When Terrell Doyley (Skengdo) and Joshua Malinga (A.M.) sang broadly similar lyrics at a concert in 2018, London's Metropolitan Police and the Crown Prosecution Service took them to be describing violent acts they had participated in and violent intentions they harbored, and the lyrics were used as the basis for legal proceedings against the singers that resulted in convictions. In this paper, I will argue that Doyley and Malinga's case illustrates a distinctive and important form that epistemic injustice can take. By failing to see their lyrics as speech that involves the exercise of their capacity for imagination, the police and prosecutors treat them as an impoverished sort of epistemic agent. I will call the wrong involved in cases like this one poetic injustice.
In this paper, we examine a number of approaches that propose new models for psychiatric theory and practices: in the way that they incorporate ‘social’ dimensions, in the way they involve ‘communities’ in treatment, in the ways that they engage mental health service users, and in the ways that they try to shift the power relations within the psychiatric encounter. We examine the extent to which ‘alternatives’ – including ‘Postpsychiatry’, ‘Open Dialogue’, the ‘Power, Threat and Meaning Framework’ and Service User Involvement in Research – really do depart from mainstream models in terms of theory, practice and empirical research and identify some shortcomings in each. We propose an approach which seeks more firmly to ground mental distress within the lifeworld of those who experience it, with a particular focus on the biopsychosocial niches within which we make our lives, and the impact of systematic disadvantage, structural violence and other toxic exposures within the spaces and places that constitute and constrain many everyday lives. Further, we argue that a truly alternative psychiatry requires psychiatric professionals to go beyond simply listening to the voices of service users: to overcome epistemic injustice requires professionals to recognise that those who have experience of mental health services have their own expertise in accounting for their distress and in evaluating alternative forms of treatment. Finally we suggest that, if ‘another psychiatry’ is possible, this requires a radical reimagination of the role and responsibilities of the medically trained psychiatrist within and outside the clinical encounter.
Psychiatrists depend on their patients for clinical information and are obligated to regard them as trustworthy, except in special circumstances. Nevertheless, some critics of psychiatry have argued that psychiatrists frequently perpetrate epistemic injustice against patients. Epistemic injustice is a moral wrong that involves unfairly discriminating against a person with respect to their ability to know things because of personal characteristics like gender or psychiatric diagnosis.
Methods
We review the concept of epistemic injustice and several claims that psychiatric practice is epistemically unjust.
Results
While acknowledging the risk of epistemic injustice in psychiatry and other medical fields, we argue that most concerns that psychiatric practice is epistemically unjust are unfounded.
Conclusions
The concept of epistemic injustice does not add significantly to existing standards of good clinical practice, and that it could produce changes in practice that would be deleterious. Psychiatrists should resist calls for changes to clinical practice based on this type of criticism.
Irrational beliefs are often associated with poor mental health and are seen as costly beliefs that should be eliminated or replaced when possible. Building on decades of empirical research, we argue that irrational beliefs are widespread in human cognition and not confined to people with poor mental health. Moreover, recent philosophical research has emphasized that irrational beliefs can be beneficial to the person holding them, not only psychologically but also epistemically, which suggests that in some cases elimination or replacement is not the most appropriate course of action. The problem emerging is how we decide when an agent’s irrational belief needs to be challenged: in this chapter, we point to the importance of the social context surrounding the agent by discussing one case of everyday confabulation whose effects vary across contexts.