A Primer on Epistemic Injustice and Patients with Non-English Language Preference

Abstract: An epistemic injustice is a wrong to a person in their capacity as a giver, receiver, and creator of knowledge. In healthcare, epistemic injustices can occur when doctor-patient interactions are complicated by language barriers between the parties. In this panel, we will describe a case study demonstrating ways in which epistemic injustice manifests for Hispanic and Spanish-speaking patients in settings characterized by English language dominance. The analysis provided here differentiates epistemic injustice in terms of hermeneutical injustice, testimonial injustice including, testimonial smothering, epistemic oppression, and epistemic colonialism. Building from other helpful typologies, this discussion is tailored to provide a resource for bioethicists, clinicians, and health policy makers, encouraging discussion about moving towards epistemic equity in U.S. healthcare. We focus on using epistemic injustice to name oppression and opportunities for resistance in the current healthcare environment. An overview of how patients can be treated unfairly as knowers is also situated with a broader national discourse about other forms of injustice and imperative to redress U.S. health and health care disparities. Attendees will engage with panelists about how addressing epistemic injustice in health care is a form of recognizing the full humanity of those with non-English language preferences.