Interpretive Injustice in Psychiatry
- ERI 149
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Philosophy PGR seminar series 2017/18
The Philosophy department's PGR seminar is an opportunity for postgraduate research students at Birmingham to present the material they are working on to the department's staff and other students. The seminar meets roughly on fortnightly Wednesdays from 15:15 to 17:00 in the ERI. All welcome!
In this paper, I argue that the dominance of a biomedical view of mental illness (roughly, one which conceives of mental illnesses as nothing more than diseases of the brain and/or nervous system) is responsible for inflicting an interpretive injustice (Fricker 2007) on many mental health service users when they interact with medical professionals. For the purposes of this paper, I define interpretive injustice as so,
A social group g suffers an interpretive injustice if,
a) There is a significant gap in the interpretive resources shared between g and some other group h with whom members of g regularly interact,
b) This gap prevents members of both g and h from understanding some aspect of the lived experience of members of g,
c) This lack of understanding significantly disadvantages members of g.
In this context, interpretive resources refer to the cognitive and epistemic tools required to interpret life experiences, including language, concepts, standards of evaluation, and procedures to effectively gather data from the world (Pohlhaus 2011). A gap in these resources is to be understood as the absence (in the sense of unavailability for use) of a certain term, concept, standard, procedure, or collection of such things.
The argument proceeds in two main steps. Firstly, I argue that a biomedical view of mental illness both pervades psychiatric practice and leads to clinicians downplaying, sometimes flatly ignoring, social and other environmental processes responsible for causing and sustaining mental illness or severe mental distress. Secondly, I argue that this misleading emphasis leads to an interpretive injustice; it results in both service users and practicing mental health professionals lacking the interpretive resources (in this case, concepts and standards of evaluation) required to make sense of the social dimensions of service users’ distress.
The details of my analysis diverge slightly from Fricker’s (2007) canonical description of interpretive injustice, in the sense that we disagree over what it takes for an interpretive injustice to be systematic (roughly, non-incedental). I close by discussing the upshot of adopting my preferred formulation for analyses of interpretive injustice more widely.