The Harm of Ableism: Medical Error and Epistemic Injustice

This paper argues that epistemic errors rooted in group- or identity-based biases, especially those pertaining to disability, are undertheorized in the literature on medical error. After sketching dominant taxonomies of medical error, we turn to the field of social epistemology to understand the rol...

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Bibliographic Details
Published in:	Kennedy Institute of Ethics journal 2019-09, Vol.29 (3), p.205-242
Main Authors:	Peña-Guzmán, David M, Reynolds, Joel Michael
Format:	Article
Language:	eng
Subjects:	Albinism Bioethics Case studies Clinical Competence Communication Critical theory Disability discrimination Disabled Persons Epistemology Ethics Exegesis & hermeneutics Humans Injustice Justice (Philosophy) Knowledge Medical errors Medical Errors - prevention & control Medical Errors - psychology Medical ethics Medicine Patients Penicillin People with disabilities Philosophy Philosophy of science Philosophy, Medical Prejudice Prevention Sex crimes Social Justice Taxonomy United States
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Summary:	This paper argues that epistemic errors rooted in group- or identity-based biases, especially those pertaining to disability, are undertheorized in the literature on medical error. After sketching dominant taxonomies of medical error, we turn to the field of social epistemology to understand the role that epistemic schemas play in contributing to medical errors that disproportionately affect patients from marginalized social groups. We examine the effects of this unequal distribution through a detailed case study of ableism. There are four primary mechanisms through which the epistemic schema of ableism distorts communication between nondisabled physicians and disabled patients: testimonial injustice, epistemic overconfidence, epistemic erasure, and epistemic derailing. Measures against epistemic injustices in general and against schema-based medical errors in particular are ultimately issues of justice that must be better addressed at all levels of health care practice.
ISSN:	1054-6863 1086-3249 1086-3249