Epistemic injustice in healthcare: a philosophial analysis
Epistemic injustice in healthcare: a philosophial analysis
复制标题
DOI：
10.1007/s11019-014-9560-2
复制
发表时间：
2014-11-01
影响因子：
2.1
通讯作者：
Kidd, Ian James
中科院分区：
文献类型：
--
作者：
Carel, Havi;Kidd, Ian James
在本文中，我们认为，病人特别容易受到弗里克所阐述的认知不公正的影响（认知不公正。权力和认识的伦理。牛津大学出版社，牛津，2007年）。病人很容易受到证言不公正的影响，因为认知不可靠和情绪不稳定等特征的推定归因会降低他们证词的可信度。病人也容易受到解释学不公正的影响，因为疾病经历的许多方面都难以理解和交流，而这往往是由于集体解释学资源的差距。然后，我们认为，认知不公正的产生部分是由于当代医疗保健服务的从业者和机构所享有的认知特权——前者是由于他们的培训、专业知识和第三人称心理学，而后者是由于他们以边缘化病人的方式隐含地享有某些阐明和证明证词的方式的特权。我们建议现象学工具包可能是改善认知不公正的努力的一部分。
In this paper we argue that ill persons are particularly vulnerable to epistemic injustice in the sense articulated by Fricker (Epistemic injustice. Power and the ethics of knowing. Oxford University Press, Oxford, 2007). Ill persons are vulnerable to testimonial injustice through the presumptive attribution of characteristics like cognitive unreliability and emotional instability that downgrade the credibility of their testimonies. Ill persons are also vulnerable to 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.