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Published in: Medicine, Health Care and Philosophy 3/2020

Open Access 01-09-2020 | Fatigue | Scientific Contribution

Striking the balance with epistemic injustice in healthcare: the case of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Author: Eleanor Alexandra Byrne

Published in: Medicine, Health Care and Philosophy | Issue 3/2020

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Abstract

Miranda Fricker’s influential concept of epistemic injustice (Oxford University Press, Oxford, 2007) has recently seen application to many areas of interest, with an increasing body of healthcare research using the concept of epistemic injustice in order to develop both general frameworks and accounts of specific medical conditions and patient groups. This paper illuminates tensions that arise between taking steps to protect against committing epistemic injustice in healthcare, and taking steps to understand the complexity of one’s predicament and treat it accordingly. Work on epistemic injustice is therefore at risk of obfuscating legitimate and potentially fruitful inquiry. This paper uses Chronic Fatigue Syndrome/Myalgic Encephalomyelitis as a case study, but I suggest that the key problems identified could apply to other cases within healthcare, such as those classed as Medically Unexplained Illnesses, Functional Neurological Disorders and Psychiatric Disorders. Future work on epistemic injustice in healthcare must recognise and attend to this tension to protect against unsatisfactory attempts to correct epistemic injustice.
Footnotes
1
There is also considerable controversy around treatment options and their effectiveness (see White et al. 2007; Geraghty and Adeniji 2019; Geraghty and Blease 2018).
 
2
Fricker later distinguished between discriminatory and distributive epistemic injustice (2013). David Coady has since compellingly argued that all forms of epistemic injustice can be understood and treated as distributive injustice (2017).
 
3
Thank you to Ian James Kidd for prompting clarification of this important distinction.
 
4
Thank you to Matthew Ratcliffe for raising this point.
 
5
Identifying this particular dualistic view of illness as problematic does not necessarily undermine the entire project of philosophical dualism in all of its forms; this deserves careful exploration elsewhere (see Maung 2019).
 
6
I thank an anonymous referee for the comment that some consider CFS/ME to be a socially constructed condition. Although the social dimensions of illness are undeniably important, this view is troublingly metaphysically loaded, endorsing a dichotomy of natural and social kinds in illness. My inclination is that endorsing such a dichotomy will not prove a constructive path to pursue here. See Hacking (1999) for more on natural and social kinds.
 
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Metadata
Title
Striking the balance with epistemic injustice in healthcare: the case of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
Author
Eleanor Alexandra Byrne
Publication date
01-09-2020
Publisher
Springer Netherlands
Keyword
Fatigue
Published in
Medicine, Health Care and Philosophy / Issue 3/2020
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-020-09945-4

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