Epistemic Injustice: Caution and Complexity

Epistemic injustice has become a ‘hot topic’ in philosophy since the 2007 publication of Miranda Fricker’s book. Project EPIC is one product of the now-enormous field of epistemic injustice studies, which extends into other academic disciplines. This industry and interest, while welcome, brings with it the usual hazards of concepts that ‘go viral’. Over time, rich concepts are reduced to slogans or single-sentence definitions. A specific vocabulary becomes widespread but decoupled from its underlying theoretical machinery (think of Kuhn on ‘paradigm shifts’).

Academic fashions are unavoidable, as are trade-offs, such as that between the complexity and the communicability of a concept. Conceptual uptake is to be encouraged where it is productive: we should not want to lock ourselves into our specialist silos. Moreover, good work can often be done with simple versions of complicated concepts. The challenge is to use concepts, like epistemic injustice, while also maintaining sensitivity to complexity, detail, and nuance.

With that in mind, here are some problematic tendencies to note in epistemic injustice studies:

1. the tendency to use the term ‘epistemic injustice’ in over-generalised ways to mean ‘anything epistemically bad’. Granted, epistemic injustices are heterogenous, but there are lots of epistemically bad things in the world. Not all of them are epistemic injustices. Other normative concepts and evaluative vocabularies are available, which may better fit different cases. Defaulting to epistemic injustice might obscure the normative details of certain cases. We must use the right concepts for the task at hand, not just the ones we are have become accustomed to using.
2. a tendency to use overly simplistic accounts of the nature, causes, harms, and wrongs of epistemic injustice. Negative stereotypes, for instance, are a cause of testimonial injustice, but not the only one. Stereotype-centred accounts are sometimes right for the case at hand, but if used carelessly can disguise the many causes of epistemic injustices. Similarly, while many hermeneutical injustices fit Fricker’s original account of the lack of relevant interpretive resources, others involve the presence of distorting resources. Other cases will involve both lacks and presences of different kinds of resources. These sorts of distinctions are vital to capturing the particularity of different cases.
3. a tendency to rely on under-articulated accounts of epistemic injustice. It is now standard to define an epistemic injustice as ‘a wrong done to someone specifically in their capacity as a knower’. However, this gloss sets up complicated questions – about the nature of the wrong, for instance, or what it means to be a knower. Sometimes, a gloss is enough, but there are many cases where the detail really matters. Many details of Fricker’s original account are not taken up, including in cases where they would help (such as the idea of ‘economies of credibility’ or her virtue-epistemological framing of testimonial justice).
4. a tendency to default to the original 2007 Frickerian framework without considering its subsequent amendments (such as the idea of structural testimonial injustice) or criticisms of the original Frickerian account or the alternative forms of epistemic injustice (such as contributory injustice) offered by other scholars. Granted, the epistemic injustice studies scholarship is enormous, and, if the original account will do the work, that’s fine. But there is much more in epistemic injustice studies than the 2007 book.

In describing these four tendencies, I am not impugning work in epistemic injustice studies. The tendencies indicate hazards to recognise and avoid. 

Here are some others, including problems particular to studies of epistemic injustice in relation to illness and healthcare:

• Doctor-bashing. Epistemic injustice within healthcare is a clear problem and there are important criticisms to make of healthcare systems. However, there is a temptation to put the concept in the service of ‘doctor-bashing’. Sometimes, individual healthcare practitioners are at fault. Even where they are, though, there can be complex causes, many involving major structural problems of healthcare systems like the NHS. Rushing to ‘bash’ individuals risks obscuring the messy personal, interpersonal, and institutional realities of healthcare practice.
• ‘Grab-bag’ approaches. Epistemic injustice as a concept clearly resonates with many people, who are then tempted to ‘grab’ the concept and immediately put it to work. However, using a concept properly means respecting its nuances and the constraints on its use. Contrary to some claims, epistemic injustices can, but need not, be systematic or lead to dehumanization. Over-defining a concept is one consequence of grab-bagging. This is not to say that only trained epistemologists should be allowed to use the concept. But it does mean that concepts, like tools, must be used with due care.
• Contesting claims. Many people experience epistemic injustices in the course of their lives. As Fricker emphasises, the concept helps those people to recognise and understand these kinds of injustice. However, not everything that one calls an epistemic injustice is an epistemic injustice. One can interpret an encounter as being epistemically unjust when it is not. It is not an epistemic injustice, for instance, if a healthcare practitioner does not automatically believe the patient’s own interpretation of their symptoms. There may be epistemically good reasons for their doing so. Questioning someone’s interpretations of their experiences is not necessarily epistemically unjust. After all, interpretations can be and are appraised – as plausible or implausible, strained or sensible, and so on. Moreover, interpretation is often be a shared task, not something a person does by themselves and then reports to others. Now, contesting claims of epistemic injustice is a delicate task. However, we will need to get better at it as the concept of epistemic injustice becomes more widely used.
• Lived experience. Epistemic injustice is often used in conjunction with the popular concept of ‘lived experience’. Unfortunately, that term is too often either undefined, underdefined, or defined in banal terms – as, say, ‘experience from the first-person perspective’. Definitional vagary is often accompanied by a tendency to draw further, very contestable epistemological claims. For instance, having ‘lived experience’ is often interpreted as a conferral of expertise. But expertise involves social roles, systems of training and accreditation, and a defined institutional context for one’s conduct. In other cases, ‘lived experience’ is asserted or implied to be something others must accept, as if being epistemic just to someone entails a generalised policy of credulous deference. Epistemic life is too complex for that. It is a matter of contexts, roles, trust and distrust, uncertainty and doubt, – of interaction, discussion, questioning, and delicately structured activities of criticism, affirmation, challenge, clarification, agreement and disagreement. We ignore all this by taking epistemic justice to involve little more than nodding along to whatever one hears.

These tendencies and challenges can all be resisted. It is perfectly possible to use the rich conceptual resources of epistemic injustice studies in ways that honour the moral and epistemic complexities of life. In the case of healthcare, such carefulness matters all the more. Much good work remains to be done – if one is careful, rigorous, and respectful of the messy complexity of our concepts and, indeed, our lives.

This post is by Ian James Kidd. 

Kidd is associate professor in the Department of Philosophy at the University of Nottingham and investigator in project EPIC. Kidd has a variety of research interests, including phenomenology, epistemology, feminist philosophy, and the philosophy of healthcare.