Epistemic negligence at the seams of permissibility: assessing epistemic injustice in bioethics
Mendoza-Cervantes, Diana Cecilia
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Recent explorations of the territory between epistemology and ethics identify a distinctively epistemic form of injustice through which an individual can be harmed in their capacity as a knower. Starting with Miranda Fricker’s important account, the growing literature on epistemic injustice has broadened our understanding of this capacity to include an individual’s participation in epistemic practices of questioning, justification, communication, and evaluation of truth. Theorists challenge Fricker’s account of prejudicial identity bias as the source of harm of epistemic injustice. An overarching goal for this paper is to provide a framework for ethical analysis of epistemic injustice that accounts for a broader conception of such epistemic harms. In particular, when scaling up our analysis of epistemic injustice from the level of individual transactions to the systemic level, monitoring identity prejudice fails to account for the bad cumulative effects that can result from a series of epistemically just interactions. The work of this paper begins with showing that such a narrow conception of bias in epistemic injustice obscures our ability to properly situate just epistemic practices within a normative framework. I introduce the notion of epistemic labor to account for the complex management of bias and argue that Fricker’s concept of innocent epistemic negligence, an intuition that one may not be blameworthy for certain instances of credibility downgrading, leads to a displacement of a shared responsibility to ensure an epistemically just interaction. I identify the source of harm of epistemic injustice as the unequal burden of this labor and argue that institutional approaches to alleviate epistemic injustice are necessary. Finally, tracking epistemic labor given a shared and pervasive risk of bias is essential in the assessment of epistemically just practices. I propose epistemic labor accountability as a framework to assess instances of epistemic injustice and use it to evaluate a dilemma in bioethics of disclosure requirements in the clinical encounter.