Hostname: page-component-788cddb947-m6qld Total loading time: 0 Render date: 2024-10-09T22:04:39.199Z Has data issue: false hasContentIssue false

Epistemic Injustice and Psychiatric Classification

Published online by Cambridge University Press:  01 January 2022

Abstract

This article supports calls for an increased integration of patients into taxonomic decision making in psychiatry by arguing that their exclusion constitutes a special kind of epistemic injustice: preemptive testimonial injustice, which precludes the opportunity for testimony due to a wrongly presumed irrelevance or lack of expertise. Here, this presumption is misguided for two reasons: (1) the role of values in psychiatric classification and (2) the potential function of first-person knowledge as a corrective means against implicitly value-laden, inaccurate, or incomplete diagnostic criteria sets. This kind of epistemic injustice leads to preventable epistemic losses in psychiatric classification, diagnosis, and treatment.

Type
Ethics, Values, and Social Epistemology
Copyright
Copyright © The Philosophy of Science Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

I have greatly benefited from the audience’s comments at the PSA 2018 in Seattle; thank you for your constructive criticisms.

References

Andreasen, Nancy C. 2006. “DSM and the Death of Phenomenology in America: An Example of Unintended Consequences.” Schizophrenia Bulletin 33:108–12.CrossRefGoogle ScholarPubMed
APA (American Psychiatric Association). 2013. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.: DSM-5. Washington, DC: APA.Google Scholar
Boorse, Christopher. 1976. “What a Theory of Mental Health Should Be.” Journal for the Theory of Social Behaviour 6:6184.CrossRefGoogle Scholar
Boorse, Christopher. 1977. “Health as a Theoretical Concept.” Philosophy of Science 44:542–73.CrossRefGoogle Scholar
Brotto, Lori A. 2010. “The DSM Diagnostic Criteria for Hypoactive Sexual Desire Disorder in Women.” Archives of Sexual Behavior 39:221–39.Google ScholarPubMed
Bueter, Anke. 2018. “Public Epistemic Trustworthiness and the Integration of Patients in Psychiatric Classification.” Synthese. doi:10.1007/s11229-018-01913-z.CrossRefGoogle Scholar
Bueter, Anke, and Jukola, Saana. 2019. “Sex, Drugs, and How to Deal with Criticism: The Case of Flibanserin.” In Uncertainty in Pharmacology: Epistemology, Methods and Decisions, ed. LaCaze, Adam and Osimani, Barbara. Dordrecht: Springer.Google Scholar
Chrisler, Joan C., and Johnston-Robledo, Ingrid. 2002. “Raging Hormones? Feminist Perspectives on Premenstrual Symptom and Postpartum Depression.” In Rethinking Mental Health and Disorder: Feminist Perspectives, ed. Ballou, Mary and Brown, Laura S., 174–97. New York: Guilford.Google Scholar
Cooper, Rachel. 2002. “Disease.” Studies in History and Philosophy of Biological and Biomedical Sciences 33:263–82.CrossRefGoogle Scholar
Cooper, Rachel. 2017. “Classification, Rating Scales, and Promoting User-Led Research.” In Extraordinary Science: Responding to the Current Crisis in Psychiatric Research, ed. Poland, Jeffrey and Tekin, Şerife, 197220. Cambridge, MA: MIT Press.Google Scholar
Cosgrove, Lisa, et al. 2006. “Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry.” Psychotherapy and Psychosomatics 75:154–60.CrossRefGoogle ScholarPubMed
Cosgrove, Lisa, and Krimsky, Sheldon. 2012. “A Comparison of DSM-IV and DSM-5 Panel Members’ Financial Associations with Industry: A Pernicious Problem Persists.” PLoS Medicine 9 (3): e1001190.CrossRefGoogle ScholarPubMed
Crichton, Paul, Carel, Havi, and Kidd, Ian J.. 2017. “Epistemic Injustice in Psychiatry.” British Journal of Psychiatry Bulletin 41:6570.Google Scholar
Dupré, John. 2007. “Fact and Value.” In Value-Free Science? Ideals and Illusions, ed. Dupré, John, Kincaid, Harold, and Wylie, Alison, 2741. Oxford: Oxford University Press.CrossRefGoogle Scholar
Flanagan, Elizabeth H., Davidson, Larry, and Strauss, John S.. 2010. “The Need for Patient-Subjective Data in the DSM and the ICD.” Psychiatry: Interpersonal and Biological Processes 73:297307.CrossRefGoogle ScholarPubMed
Fricker, Miranda. 2007. Epistemic Injustice: Power and the Ethics of Knowing. Oxford: Oxford University Press.CrossRefGoogle Scholar
George, Bill. 2010. “What’s in a Name? Client Participation, Diagnosis, and the DSM-5.” Journal of Mental Health 19:479–82.CrossRefGoogle Scholar
Hawthorne, Susan C. C. 2010. “Institutionalized Intolerance of ADHD: Sources and Consequences.” Hypatia 25:504–26.CrossRefGoogle Scholar
Hoffman, Ginger A., and Zachar, Paul. 2017. “RDoC’s Metaphysical Assumptions: Problems and Promises.” In Extraordinary Science: Responding to the Current Crisis in Psychiatric Research, ed. Poland, Jeffrey and Tekin, Şerife, 5986. Cambridge, MA: MIT Press.Google Scholar
Horwitz, Allan V., and Wakefield, Jerome C.. 2012. The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. Oxford: Oxford University Press.Google Scholar
Hyman, Stephen E. 2010. “The Diagnosis of Mental Disorders: The Problem of Reification.” Annual Revue of Clinical Psychology 6:155–79.Google Scholar
Insel, Thomas. 2013. “Transforming Diagnosis.” Director’s blog, National Institute of Mental Health, April 29. https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml.Google Scholar
Insel, Thomas, et al. 2010. “Research Domain Criteria (RDOC): Toward a New Classification Framework for Research on Mental Disorders.” American Journal of Psychiatry 167:748–51.CrossRefGoogle Scholar
Kendler, Kenneth S. 2016. “The Phenomenology of Major Depression and the Representativeness and Nature of DSM Criteria.” American Journal of Psychiatry 173:771–80.CrossRefGoogle ScholarPubMed
Kendler, Kenneth S., et al. 2009. “Guidelines for Making Changes to DSM-V.” Revised October 21. American Psychiatric Association, Washington, DC.Google Scholar
Kidd, Ian A., and Carel, Havi. 2017. “Epistemic Injustice and Illness.” Journal of Applied Philosophy 34:172–90.CrossRefGoogle ScholarPubMed
Kurs, Rena, and Grinshpoon, Alexander. 2017. “Vulnerability of Individuals with Mental Disorders to Epistemic Injustice in Both Clinical and Social Domains.” Ethics and Behavior 28:111.Google Scholar
Laing, Ronald D. 1967. The Politics of Experience. London: Penguin.Google Scholar
Lane, Christopher. 2007. Shyness: How Normal Behavior Became a Sickness. New Haven, CT: Yale University Press.Google Scholar
Longino, Helen E. 1990. Science as Social Knowledge: Values and Objectivity in Scientific Inquiry. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
Melamed, Yuval. 2008. “Testimony by Mentally Ill Individuals.” Journal of the American Academy of Psychiatry and the Law 36:393–97.Google ScholarPubMed
Murphy, Dominic. 2006. Psychiatry in the Scientific Image. Cambridge. MA: MIT Press.Google Scholar
Musschenga, Albert W., van der Steen, Wim J., and Ho, Vincent K. Y.. 2010. “The Business of Drug Research: A Mixed Blessing.” In The Commodification of Academic Science, ed. Radder, Hans, 110–31. Pittsburgh: Pittsburgh University Press.Google Scholar
Parnas, Josef, and Sass, Louis A.. 2003. “Schizophrenia, Consciousness, and the Self.” Schizophrenia Bulletin 29:427–44.Google Scholar
Pohlhaus, Gaile Jr. 2012. “Relational Knowing and Epistemic Injustice: Toward a Theory of Willful Hermeneutic Ignorance.Hypatia 27:715–35.CrossRefGoogle Scholar
Regier, Darrel A., Kuhl, Emily A., and Kupfer, David J.. 2013. “The DSM-5: Classification and Criteria Changes.” World Psychiatry 12:9298.CrossRefGoogle ScholarPubMed
Sadler, John Z. 2005. Values and Psychiatric Diagnosis. Oxford: Oxford University Press.Google Scholar
Sadler, John Z., and Fulford, Bill. 2004. “Should Patients and Their Families Contribute to the DSM-5 Process?Psychiatric Services 55:133–38.CrossRefGoogle Scholar
Scrutton, Anastasia P. 2017. “Epistemic Injustice and Mental Illness.” In The Routledge Handbook of Epistemic Injustice, ed. Kidd, I., Medina, J., and Pohlhaus, G., 347–55. New York: Routledge.Google Scholar
Sisti, Dominic, and Johnson, Rebecca. 2015. “Revision and Representation: The Controversial Case of DSM-5.” Public Affairs Quarterly 29:76108.Google Scholar
Spitzer, Robert L. 2004. “Good Idea or Politically Correct Nonsense?Psychiatric Services 55:113.CrossRefGoogle ScholarPubMed
Stein, Dan J., and Phillips, Katherine A.. 2013. “Patient Advocacy and DSM-5.” BMC Medicine 11:133.CrossRefGoogle ScholarPubMed
Szasz, Thomas. 1974. The Myth of Mental Illness: Foundations of a Theory of Personal Conduct. New York: Harper & Row.CrossRefGoogle Scholar
Tekin, Şerife. 2015. “Against Hyponarrating Grief: Incompatible Research and Treatment Interests in the DSM-5.” In The DSM-5 in Perspective: Philosophical Reflections on the Psychiatric Babel, ed. Demazeux, Steeves and Singy, Patrick, 179–97. Dordrecht: Springer.Google Scholar
Tiefer, Leonore. 2006. “Female Sexual Dysfunction: A Case Study of Disease Mongering and Activist Resistance.” PLoS Medicine 3: e178.CrossRefGoogle ScholarPubMed
Tsou, Jonathan Y. 2015. “DSM-5 and Psychiatry’s Second Revolution: Descriptive vs. Theoretical Approaches to Psychiatric Classification.” In The DSM-5 in Perspective: Philosophical Reflections on the Psychiatric Babel, ed. Demazeux, Steeves and Singy, Patrick, 4362. Dordrecht: Springer.Google Scholar
Wakefield, Jerome C. 1992. “The Concept of Mental Disorder: On the Boundary between Biological Facts and Social Values.” American Psychologist 47:373–88.CrossRefGoogle ScholarPubMed