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作为认知不公正对象的心理健康专家——以自闭症谱系障碍为例

Mental Health Experts as Objects of Epistemic Injustice-The Case of Autism Spectrum Condition.

作者信息

Wodziński Maciej, Moskalewicz Marcin

机构信息

Institute of Philosophy, Maria Curie-Skłodowska University, M. Curie-Skłodowska sq. 4, 20-031 Lublin, Poland.

Doctoral School of Humanities, Maria Curie-Skłodowska University, Weteranów 18, 20-038 Lublin, Poland.

出版信息

Diagnostics (Basel). 2023 Mar 1;13(5):927. doi: 10.3390/diagnostics13050927.

Abstract

This theoretical paper addresses the issue of epistemic injustice with particular reference to autism. Injustice is epistemic when harm is performed without adequate reason and is caused by or related to access to knowledge production and processing, e.g., concerning racial or ethnic minorities or patients. The paper argues that both mental health service users and providers can be subject to epistemic injustice. Cognitive diagnostic errors often appear when complex decisions are made in a limited timeframe. In those situations, the socially dominant ways of thinking about mental disorders and half-automated and operationalized diagnostic paradigms imprint on experts' decision-making processes. Recently, analyses have focused on how power operates in the service user-provider relationship. It was observed that cognitive injustice inflicts on patients through the lack of consideration of their first-person perspectives, denial of epistemic authority, and even epistemic subject status, among others. This paper shifts focus toward health professionals as rarely considered objects of epistemic injustice. Epistemic injustice affects mental health providers by harming their access to and use of knowledge in their professional activities, thus affecting the reliability of their diagnostic assessments.

摘要

这篇理论性论文探讨了认知不公正问题,尤其涉及自闭症。当伤害在没有充分理由的情况下发生,且是由获取知识生产和处理(例如涉及种族或少数族裔或患者)导致或与之相关时,这种不公正就是认知性的。该论文认为,心理健康服务使用者和提供者都可能遭受认知不公正。在有限的时间内做出复杂决策时,往往会出现认知诊断错误。在这些情况下,社会上对精神障碍的主导思维方式以及半自动化和可操作化的诊断范式会影响专家的决策过程。最近,分析集中在权力如何在服务使用者与提供者的关系中运作。据观察,认知不公正通过忽视患者的第一人称视角、否认认知权威甚至认知主体地位等方式加诸于患者身上。本文将重点转向很少被视为认知不公正对象的健康专业人员。认知不公正通过损害心理健康提供者在其专业活动中获取和使用知识的机会,从而影响其诊断评估的可靠性,进而对他们产生影响。

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本文引用的文献

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The downgrading of pain sufferers' credibility.贬低疼痛患者的可信度。
Philos Ethics Humanit Med. 2021 Oct 6;16(1):8. doi: 10.1186/s13010-021-00105-x.
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Epistemic injustice, children and mental illness.认知不公正、儿童与精神疾病
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