Epistemic justice is both a legitimate and an integral goal of psychiatry: a reply to Kious, Lewis and Kim (2023)

Psychological Medicine (forthcoming)
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Abstract

In a recent Editorial, Kious et al. (2023) put forward the claim that psychiatrists should resist calls to integrate concerns about epistemic injustice into their practice as this concept not only fails to add significantly to the current professional standards but would also lead to deleterious clinical outcomes. We believe their claim is mistaken, as it arises from several misconceptions about both the nature of epistemic injustice, and its clinical relevance. First, epistemic justice is conflated with what the authors term ‘a quest for social justice’ that could ‘sideline principles of good clinical reasoning’ (Kious at al 2023: 4). Second, the claim about the impracticality and/or counterproductivity of epistemic injustice as a critical tool within psychiatric practice reflects a series of misconceptions about the normative framework from which this concept derives, so the standards they evaluate it against are ill-chosen. Pace Kious at al., fostering epistemic justice in any area of knowledge and inquiry could not – unwittingly or otherwise – inhibit the consideration of relevant evidence, restrict sound argument or facilitate the casual treatment of testimonies at face value. Third and final, this claim obfuscates some immediate ways in which a focus on epistemic justice as an integral goal will strengthen psychiatric practice according to its own internal standards.

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Lubomira Radoilska
University of Kent

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