The term “Content Focused Epistemic Injustice” refers to a specific form of injustice stemming from the uneven distribution of knowledge within a social group. This injustice arises when certain social groups are deprived of access to specific knowledge or information that is essential for them to gain a true understanding of certain matters. As a result, they are unable to make well-informed decisions regarding the subject matter, leading to epistemic injustice. Dembroff argues that content- focused epistemic injustice is a form of oppression because it can have significant consequences to social groups and individuals however one may ask the question, is epistemic injustice truly oppressive? 

In order to answer this question we must look at what oppression as well as what epistemic injustice really is. Oppression is a form of social injustice that is caused by the imbalance of power, privilege and resources which allows certain groups to dominate, oppress and discriminate against others. Epistemic injustice refers to the unjust treatment of individuals based on their knowledge, experiences or credibility. Epistemic injustice denies individuals their right to be heard, valued and recognized. When certain groups are dismissed based on their race, gender status and many other factors, this unjust treatment is oppressive and illustrates imbalanced power dynamics. 

One type of epistemic injustice is testimonial injustice.Testimonial injustice occurs when a person’s credibility is lowered and the weight of their testimony is unjustly diminished due to their identity, or prejudice. Individuals from marginalized groups are an example of an instance of this case as they might be seen as less reliable, doubted or disregarded due to their identity which results in testimonial injustice. Testimonial injustice can reinforce stereotypes and bias, and limit access to opportunities which contributes to marginalization. Consequently, testimonial injustice is a form of oppression. 

Hermeneutical injustice is the second type of epistemic injustice. Hermeneutical injustice refers to when an individual is unable to articulate or understand a harmful experience because of a structural identity prejudice and due to this they are dismissed. The reason that hermeneutical injustice is oppressive is because it leads to exclusion.  It excludes certain individuals or groups from participating in knowledge production in addition to decision making processes because of a lack of shared social knowledge. This exclusion emphasizes the power imbalance and denies individuals opportunities. As a result, hermeneutical injustice perpetuates systemic oppression.

One instance of testimonial injustice highlighted by Dembroff pertains to the HIV threat during the 1980s and 1990s. During that period, HIV was largely dismissed and lacked adequate funding. This dismissive attitude stemmed from HIV being stigmatized as “the gay disease,” leading to its lack of serious consideration. As a result, the importance of HIV research and its relevance for safeguarding public health was disregarded, resulting in hardship and burden for the American population. This serves as a prime example of epistemic injustice, as the limited knowledge about the severity of HIV hindered individuals from making well-informed decisions, ultimately risking the lives of numerous Americans. 

Looking at this example we can ask the question, was this oppressive? One may argue that because of the lack of information regarding this issue, the Reagan’s administration did not understand the severity of the illness. Consequently, they were unable to make a correct and an informed decision, thus they didn’t have intentions in harming the lives of numerous Americans. This would make the intentions of the Reagan’s administration not oppressive because it was not their fault that they lacked information due to it being a new illness. However, let’s look at what the Reagan’s administration did know before making this decision, to refuse funding and extensive research on this illness.  Reagan’’s officials were aware that this was a quickly spreading disease, as well as the fact that numerous people from the gay community were catching this illness. Not only did Reagan’s officials refer to HIV as “the gay disease” but they interpreted the support for prevention research as support for the gay community. This illustrates that Reagan’s officials believed that HIV and the gay community were highly correlated and due to this they rejected expert testimony that HIV research was needed in order to protect public health. This clearly represents oppression because Reagan’s officials made an unjust decision with the intention to harm the gay community. 

This decision to refuse funding and research not only marginalized the LGBT community but discredited them as well. Reagan’s administration did not value their opinions nor accepted that HIV was deadlier than they thought. This decision reinforced the Reagans administration being the dominant group of the two and having greater authority which led them to have control over what defined what they thought was legitimate and serious enough which is oppressive.

Not only was refusing funding caused by oppressive values, but the result of this decision also led to oppression. Epistemic injustice can create unequal opportunities for individuals or groups to contribute to knowledge production because they are dismissed which limits the diversity of knowledge on the basis of a biased understanding. If Americans had the knowledge that HIV was a serious illness, they would be much more cautious and are more likely to be protected from it. Because the LGBT community was dismissed, their voices were silenced which led people to make decisions without this knowledge of people catching HIV and how to prevent yourself from receiving it causing such a serious harm that could have been prevented. The decision to choose not to research transmission prevention was an oppressive act.

Another reason why this instance was oppressive was because it reinforced the stereotype and prejudice of the LGBT community, calling it a “gay disease”. Not only did this cause a harmful narrative to spread but also silenced their voices even more because they were fearful of the stigma. At this time there was also a lack of accurate knowledge about the virus and its transmission which was another factor that contributed to misconceptions, fear and moral judgements surrounding HIV. As a result people with this virus faced prejudice, and discrimination due to the misunderstanding about this virus. As shown, epistemic injustice contributes to stereotypes, marginalization and discrimination of different groups of people.

Another instance of epistemic injustice is when people assign children less credibility and less reliability because of their young age and because they aren’t able to articulate themselves as well. “Consider the case of a 5-year-old girl who presented with an acute headache and was found to have double vision on examination of her eye movements: a concerning feature warranting a CT scan. On repeated examination she was, however, found to complain of double vision even with one eye closed. As a result, the girl’s testimony was then dismissed. Fortunately, another physician reviewed the patient and realized she was trying to describe blurred vision. Result: this and the headache were fixed by a trip to the opticians and the CT was canceled. The girl lacked the epistemic resources to describe her symptoms accurately but was in fact conveying important information. This scenario shows how easy it can be to overlook the intended meaning of a child’s testimony.”  This is an example of epistemic injustice because the child was assigned a lower level of credibility thus not taken as seriously and therefore treated unequally. 

Can this be classified as oppression? This might seem silly to classify as oppression because how can someone be oppressive towards children. The doctor obviously didn’t have anything against children nor intended to treat them unequally as others. However, on the other hand if we look back, the definition of oppression is, “a form of social injustice that is caused by the imbalance of power”. The doctor-patient relationship involves a power imbalance with the doctor possessing greater knowledge, authority and expertise. This power imbalance can contribute to the child being dismissed. Although the doctor didn’t have malicious intentions nor hatred towards children, this was an instance of social injustice because the doctor didn’t take the child seriously and dismissed how she was feeling. Children are often perceived as lacking knowledge or experience, and this age based bias can lead to healthcare professionals to downplay a child’s concerns. This illustrates a child receives lower credibility due to being a child and not being able to accurately describe their symptoms which caused unfair treatment. This goes to show that epistemic injustice doesn’t necessarily have to stem from prejudice against different races or social groups but can also occur merely from someone not being taken as seriously due to their characteristics, their age, and their gender. Dismissing a child’s input because of their age, denies them the opportunity to share knowledge. This exclusion reinforces the power imbalance. Regardless of the intentions, the actions leading to epistemic injustice are oppressive.

Another instance in which people are vulnerable to epistemic injustice is psychiatric patients. There is so much stigma and negative stereotypes when it comes to psychiatric patients that some people don’t believe that these patients are credible and therefore undermine their understanding. For instance, Havi Harvol states, “Epistemic injustice is important in psychiatry because of the persistent negative stereotypes that affect people with mental disorders in particular and lead to a credibility deficit. The consequence is that patient testimonies and interpretations are not acknowledged as credible, and patients are thus undermined in their capacity as knowers and contributors to the epistemic effort to reach a correct diagnosis and treatment. We suggest that people with mental disorders are even more susceptible to epistemic injustice than those with physical illnesses, for reasons that are detailed below. We have argued in the past that people with physical illnesses are vulnerable to epistemic injustice. Here we suggest that people with mental disorders may be susceptible to even greater epistemic injustice than people with physical illnesses. This is mainly owing to the high prevalence and great power of negative stereotypes of psychiatric illness. As a consequence, the patient may be telling the truth, but the doctor deflates the level of credibility which she gives to the patient (‘credibility deficit’) and thereby does the patient a distinctive kind of injustice, namely epistemic injustice, which undermines the patient specifically in her capacity as a giver of knowledge.” This portrays a testimonial injustice as psychiatric patient’s testimonies are not acknowledged as credible, or taken as serious because of their identity. Society may perceive them as irrational, unreliable and because of this a doctor will undermine their ability to articulate their experiences and insights. There is a significant power imbalance when it comes to doctor-patient relationships as the doctor holds the authority and expertise which contributes to the injustice as the patient’s narrative may be downplayed or dismissed. This is oppressive because it can lead to several consequences consisting of a hinder in their recovery process, addition to their mental health struggles and a feeling of disempowerment all stemmed by their identity. 

This clarifies that testimonial injustice against psychiatric patients is a form of oppression that silences their voices, perpetuates stereotypes, and limits them. Recognizing and addressing this injustice is crucial for promoting patient-centered care, destigmatizing mental health, and fostering a more inclusive society. Professionals as well as society at large must work to dismantle testimonial injustice by valuing and amplifying the testimonies of psychiatric patients, challenging stereotypes, and empowering individuals to share their stories and experiences without fear of dismissal or judgment. Only by embracing a more inclusive and respectful approach can we create a system that promotes the well-being and dignity of all individuals, regardless of their psychiatric condition.

Whether epistemic injustice is considered truly oppressive depends on one’s perspective and the specific circumstances involved. From the standpoint of those who experience it, epistemic injustice can be deeply oppressive as it undermines their credibility. It can restrict opportunities, perpetuate stereotypes, and marginalize certain groups or individuals, by devaluing or silencing their knowledge and perspectives, epistemic injustice reinforces existing power imbalances and can hinder progress towards equality and social justice. Recognizing and addressing epistemic injustice creates an inclusive space where people are given the opportunity to be heard, respected and involved in decision making. It involves valuing their perspective and acknowledging that they possess valuable insight. Ways we can prevent epistemic injustice is by recognizing diverse forms of knowledge, challenging stereotypes/biases, reflecting on power dynamics, and validating experiences. By doing this we can create an inclusive, understanding and comfortable space, free from oppression. 

Citations 

Crichton, P., Carel, H., & Kidd, I. J. (2017, April). Epistemic injustice in psychiatry. BJPsych bulletin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376720/#:~:text=The%20prime%20case%20of%20epistemic,examples%20include%20sexism%20and%20racism. 

Seen but not heard: Children and epistemic injustice – the lancet. (n.d.). https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61759-1/fulltext 

~ 1000-Word Philosophy: An Introductory Anthology. (2023, March 19). Epistemic injustice. 1000. https://1000wordphilosophy.com/2020/07/21/epistemic-injustice/