Look for injustice and you’ll probably find it: a commentary on Harcourt’s ‘epistemic injustice, children and mental illness’

Journal of Medical Ethics 47 (11):736-737 (2021)
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In ‘Epistemic injustice, children and mental Illness,’1 Edward Harcourt uses Miranda Fricker’s concept of testimonial injustice 2 to make sense of claims, from mental health service users, that clinicians do not listen to them. Being listened to matters. It is a sign of respect as a person and associated with better clinical outcomes. TI involves suffering an unfair credibility deficit because of prejudice, so seems like a promising way of understanding service users’ complaints. Harcourt quickly concludes, however, that it is inadequate. Since many service users are not wholly rational, the credibility deficits they suffer could be fair, and thus cannot constitute TI. Undaunted, Harcourt tries to reimagine TI so it can help. He observes that many children are also unfairly discredited by clinicians. Perhaps they are victims of TI, too, in a way that could help resurrect the concept? It may at first seem not: although providers who work with children often discredit them, this may result from mere ignorance, not prejudice. We should not let clinicians off the hook so easily, however, since they work with children, and should know their real capacities. Since they still discredit children, they must be prejudiced. And even further kinds of TI could be perpetrated by clinicians. Fricker assumes that …



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Brent Kious
University of Utah

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