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Published in: Medicine, Health Care and Philosophy 4/2023

Open Access 19-09-2023 | Scientific Contribution

First-person disavowals of digital phenotyping and epistemic injustice in psychiatry

Authors: Stephanie K. Slack, Linda Barclay

Published in: Medicine, Health Care and Philosophy | Issue 4/2023

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Abstract

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which can be instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry.
Footnotes
1
Others have argued that the mere absence of ‘objective’ markers can itself diminish a person’s credibility, such as for those suffering chronic pain. See Buchman et al. (2017) and Pozzi (2023).
 
2
Some suggest the perception of Artificial Intelligence (AI) as a superior form of knowledge may result in AI predictions being given more epistemic weight than both clinicians and patients. See McCradden et al. (2023).
 
3
Of course, there will likely also be cases where the clinician disagrees with the result of the digital phenotyping tool which may challenge the ?objectivity? of digital phenotyping on different grounds to the argument we pursue here. Such a scenario is beyond the scope of this paper, but we thank an anonymous reviewer for raising this point.
 
4
It is worth noting that claims about privileged first-person knowledge about what it is like to have a mental illness and what it is like to experience mental health treatment can be supported by, but do not depend on the truth of, standpoint theory (cf.
Hartsock (1983), Harding (1986) and Collins (1990). The claim can also be supported by the very uncontroversial notion that one can acquire knowledge from experience, or, as is common to say more recently, ‘lived experience’.
 
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Metadata
Title
First-person disavowals of digital phenotyping and epistemic injustice in psychiatry
Authors
Stephanie K. Slack
Linda Barclay
Publication date
19-09-2023
Publisher
Springer Netherlands
Published in
Medicine, Health Care and Philosophy / Issue 4/2023
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-023-10174-8

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