ABSTRACT
This chapter explores the relation of epistemic injustice to medicine and healthcare as they arise from epistemic asymmetries and differential power relations. Healthcare systems rely on complex structures of epistemic norms and expectations, both implicit and explicit, that create knowledge asymmetries – for instance, privileging the knowledge derived from medical training and theory, rather than that potentially rooted in patient experience, which effectively limits epistemic authority to healthcare practitioners. The privileging of certain forms of experience amplifies this by creating experiential asymmetries: phenomenologists of illness have disclosed how ill persons experience both their illness and the social world, including healthcare environments (Toombs 1987). Chronically ill patients, in particular, experience their illness not as localized biological dysfunction, but as ongoing, pervasive, perhaps all-encompassing – a definitive ‘mode of being’. Although illness may be only one aspect of that ‘mode’ or way of life, it can come to dominate their identity either as they conceive it, or, more significantly, as others do.
