title: Epistemic injustice and responsibility in borderline personality disorder.
abstract: Miranda Fricker's concept of epistemic injustice has been quite a novel idea in epistemology. It brings something new to the fields of epistemology and ethics. Fricker draws our attention to a distinctive species of injustice, the epistemic injustice, in which someone is specifically wronged in his capacity as a knower. There has been a significant amount of work done in epistemic injustice, both in race and gender studies. The application of the concept in the context of mental health is less explored. Here, we aim to apply the concept of epistemic injustice in attributing responsibility to patients with borderline personality disorder. Attributing responsibility involves holding someone accountable for his presumed wrongdoings, making judgments on whether the agent has control on his action, on whether is aware of its consequences. It is generally agreed that in order to be morally responsible for an action the person should be worthy of praise or blame for it. Following Aristotle, we focus on epistemic condition in attribution of responsibility. We will discuss the role of epistemic injustice in assessment of epistemic condition of responsibility. We will show that we can misinterpret the agent's intentions because of the presence of systematic prejudices. We will focus on patients suffering from borderline personality disorder. We provide a case vignette to show a tendency in the professionals in holding these patients responsible for their action when it can be argued otherwise. We argue that prejudice against the patient with borderline personality disorder where the person is seen as manipulative plays a significant role in the process of epistemic injustice. The suggested manipulative nature of patients with borderline personality disorder leads to professionals to ascribe agency and knowledge where it is not due.
authors: South London and Maudsley NHS Foundation Trust & Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
authors: Michalis
authors: M
authors: Kyratsous
authors: North East London NHS Foundation Trust, Ilford, UK.
authors: Abdi
authors: A
authors: Sanati
mesh_terms: D001291:Attitude of Health Personnel; D001883:Borderline Personality Disorder / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009014:Morals; D010686:Philosophy, Medical; D011287:Prejudice / Q000941:ethics*; D011369:Professional-Patient Relations
keywords: epistemology; evaluation; medical ethics