Temporal Aspects of Epistemic Injustice: The Case of Patients with Drug Dependence.

J Bioeth Inq

Institut für Philosophie, Goethe-Universität Frankfurt, Norbert-Wollheim-Platz 1, 60629, Frankfurt am Main, Germany.

Published: January 2025

AI Article Synopsis

  • Scholars differentiate between testimonial and hermeneutical epistemic injustice in healthcare; the former involves negative stereotypes, while the latter deals with a lack of understanding in the dominant culture about a patient's illness experience.
  • The paper focuses on drug-dependent patients and discusses three temporal dimensions of epistemic injustice: their cognitive processes, personal experiences of time, and the mismatch between social timing and available care resources.
  • The authors argue that these temporal issues do not fit neatly into the existing categories of testimonial or hermeneutical injustice, highlighting the complexities of addressing epistemic injustice in healthcare.

Article Abstract

Scholars usually distinguish between testimonial and hermeneutical epistemic injustice in healthcare. The former arises from negative stereotyping and stigmatization, while the latter occurs when the hermeneutical resources of the dominant community are inadequate for articulating the experience of one's illness. However, the heuristics provided by these two types of epistemic predicaments tend to overlook salient forms of epistemic injustice. In this paper, we prove this argument on the example of the temporality of patients with drug dependence. We identify three temporal dimensions of epistemic injustice affecting drug-dependent patients: the temporal features of their cognitive processes, their individual temporal experience, and the mismatch of social temporality. Notably, the last aspect, which highlights the disparity between the availability of care and its accessibility, does not fit neatly into the categories of testimonial or hermeneutical injustice. (We should note that the International Network of People Who Use Drugs (INPUD) and The Asian Network of People who use Drugs (ANPUD) consider the term "drug addiction" to be associated with disempowerment and negative stereotyping. Instead, they suggest the expression "drug dependence" (INPUD 2020). However, the concept of "drug addiction" is still being used in the current public health, philosophy, and sociology debates that concern the specific field of addiction studies. Replacing the notion of drug addiction with "drug dependence" would not eliminate existing epistemic injustices or allow us to avoid creating new ones, such as those related to ignoring pain claims (O'Brien 2011). Still, for the sake of clarity we will use the notion "drug dependence" when speaking of people while retaining the term "drug addiction" for labelling healthcare practices and the topic for philosophy of healthcare.).

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http://dx.doi.org/10.1007/s11673-024-10404-5DOI Listing

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  • Scholars differentiate between testimonial and hermeneutical epistemic injustice in healthcare; the former involves negative stereotypes, while the latter deals with a lack of understanding in the dominant culture about a patient's illness experience.
  • The paper focuses on drug-dependent patients and discusses three temporal dimensions of epistemic injustice: their cognitive processes, personal experiences of time, and the mismatch between social timing and available care resources.
  • The authors argue that these temporal issues do not fit neatly into the existing categories of testimonial or hermeneutical injustice, highlighting the complexities of addressing epistemic injustice in healthcare.
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