EPIC Seminar: Expertise, Lived Experience and Legal Processes

 Sheelagh McGuinness reports from an EPIC seminar in February 2026.

In February 2026 EPIC hosted the first in a series of seminars examining the relationship between legal processes and epistemic injustice. The event brought together researchers from philosophy, law, and social science to consider how legal and regulatory frameworks can exacerbate or ameliorate the epistemic marginalisation of those who engage with them.

Professor Lisa Bortolotti (EPIC/University of Birmingham) opened with a conceptual analysis of expertise and its relationship to epistemic injustice, arguing that expertise should be understood both in terms of the knowledge an individual possesses and as a form of performance in a particular environmental context. An agent may hold relevant expertise yet be unable to exercise it if the conditions necessary for effective performance are not in place. Examples include not being invited to contribute, if space constrains or excludes their perspective, or if their testimony is challenged or reframed without genuine engagement.

Bortolotti paid particular attention to experts by experience, focusing on people with lived experience of mental health services participating in healthcare research. She identified three stages at which such expertise may be obstructed: exclusion from participation entirely; inclusion on terms that do not permit meaningful contribution; and formal inclusion accompanied by insufficient uptake of testimony. Each stage, she argued, can be understood through existing concepts in the epistemic injustice literature, including participatory injustice and testimonial injustice.

You can read more about this research here.

Dr Lucy Series (University of Bristol) introduced the labyrinthine world of mental health and mental capacity law, offering an account of how lived experience has (or has not) shaped these frameworks in England and Wales. Series’ presentation began by outlining the commonly accepted distinction of mental health law as a coercive instrument and mental capacity law as a more benign mechanism for substitute decision‑making in a person’s best interests. She proceeded to detail the ways in which this distinction is inaccurate. In particular, she highlighted how the 2005 Mental Capacity Act can in practice authorise detention and involuntary treatment and often with fewer procedural safeguards than those available under the 1983 Mental Health Act.

Series traced the involvement of disabled people and mental health service users in shaping these legal frameworks over several decades. She concluded by considering the relationship between legal complexity and genuine participation. Where legal frameworks are highly technical and their implications difficult to foresee, consultation processes that do not invest in participant understanding risk generating outcomes that diverge sharply from what advocates intended. She closed by asking what structural conditions are necessary for expertise by experience to be genuinely incorporated into legal and regulatory processes.

The final presentation applied the conceptual frameworks outlined in earlier presentations to empirical research on bereaved families' experiences of two distinct legal processes: coroner's inquests and fitness to practise hearings. Professor Sara Ryan (Manchester Metropolitan University) presented findings from research with family members who had engaged with these processes following healthcare-related harm, including the deaths of relatives with learning disabilities or autism. You can read more about this research here.

Families reported entering these processes as relative novices, surrounded by professionals whose familiarity with procedural norms gave them significant epistemic advantage. Families were expected to provide instruction without understanding what that meant procedurally, leading to a form of disconnection that Ryan characterised as epistemic marginalisation. The fitness to practise hearings produced comparable difficulties including:

• witness statements were altered or reduced in scope without notification
• charges were revised between referral and hearing
• participants who had prepared to give evidence were informed at very short notice that their testimony was no longer required.

Some participants stated that they would not make a referral again and one described the fitness to practise process as more distressing than the bereavement itself.

Ryan concluded by emphasising how modest reforms, for example, clearer communication, named contacts, and acknowledgement of the person who died as an individual have the potential to meaningfully ameliorate epistemics injustices.

The event offered compelling insights into how epistemic injustice operates across healthcare, law, and regulatory practice. A consistent pattern emerged across all three contexts (through the obstruction of expertise by experience in clinical settings, the failure of legal frameworks to meaningfully incorporate the perspectives of those they affect, and the systematic marginalisation of bereaved families in coronial and fitness to practise processes). The people with the biggest stake in these processes are routinely denied the epistemic standing to influence them. Addressing this requires not only conceptual clarity about what epistemic justice demands but also sustained attention to the structural and institutional conditions that make genuine participation possible.

Sheelagh McGuinness

Sheelagh McGuinness is professor of law at the Centre for Health Law and Society, University of Bristol. Her research interests include the regulation of reproduction, and health law more generally. Sheelagh is currently a co-investigator on two projects: Epistemic injustice in healthcare funded by the Wellcome Trust and Reproductive Borders and Bordering Reproduction (RBBR): Access to Care for Women from Ethnic Minority and Migrant Groups funded by the AHRC. Sheelagh is a member of the Board of Trustees of the British Pregnancy Advisory Board (BPAS).