Wardrope, A. orcid.org/0000-0003-3614-6346 and Stewart, H. (2024) Epistemic privilege, phenomenology and symptomatology in functional/dissociative seizures. Social Epistemology, 39 (2). pp. 134-149. ISSN 0269-1728
Abstract
Much work on clinical testimony assumes that none can know better than the patient what they experience. We show that in certain contexts this assumption is unwarranted; clinician expertise encompasses disease phenomenology, to the extent that the clinician may know better than the patient what the patient is experiencing or has experienced. Conversations between clinicians and people with functional/dissociative seizures (FDS) show that initial phenomenological reports of FDS (what we call ‘surface’ phenomenology) are often inconsistent with more fine-grained descriptions produced after detailed inquiry (‘reflective’ phenomenology). Assuming the initial reports are made in good faith, this process involves the clinician showing the patient something about their experience they did not already (explicitly) know. Failure to engage in this reflective process can result in misdiagnosis and mistreatment. Thus, uncritical acceptance of patient testimony – an unwarranted credibility excess – may be as harmful as its unwarranted dismissal. We conclude that: the epistemically just clinician cannot rely on expertise in le corps objectif alone, they must also cultivate an understanding of le corps propre for the patients they encounter; and epistemic (in)justice cannot be considered solely something a clinician does to the patient. Instead, epistemic justice in the clinical encounter is an intrinsically collaborative process.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent. |
Keywords: | Epistemic injustice; phenomenology; seizure disorders; testimony |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > Department of Neuroscience (Sheffield) |
Funding Information: | Funder Grant number DEPARTMENT OF HEALTH AND SOCIAL CARE NIHR201992 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 31 Oct 2024 08:46 |
Last Modified: | 12 Mar 2025 15:03 |
Status: | Published |
Publisher: | Informa UK Limited |
Refereed: | Yes |
Identification Number: | 10.1080/02691728.2024.2400066 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:219034 |