Epistemic injustice and care-related decision making

  • Nicola Blunden (Speaker)

Activity: Talk or presentationOral presentation


Decision-making about care involves complex, nuanced practical
reasoning. Such reasoning will partly reflect professional expertise:
knowledge of relevant bodies of evidence, and fluency in ways
of speaking, judging, and practising. It will (or should) also be
shaped significantly by the dynamics of the relationship between
practitioner and service-user, or care-giver and care-receiver.
Those dynamics are importantly constitutive of what care is, and
of the way it plays out in any particular situation.
This presentation offers a conceptual analysis of some of the
issues which arise in this context. It is framed around two themes.
One is the centrality of knowledge in the care relationship. So the
ways in which people know things, and how they talk about them,
and the relative status accorded to different ways of knowing and
speaking, are all materially at stake in every care-based encounter.
The second is the concept of economic injustice, as developed by
Miranda Fricker (2007) and since taken up and applied in a variety
of social settings. Economic injustice concerns wrongs which may
be done to someone specifically as the kind of ‘knower’ they are.
It may happen where a speaker is not taken seriously, or has not
been given the resources to make sense of their experiences, or
the situation they find themselves in. Putting these two themes
together, Dr. Calder and Ms. Blunden suggest, illuminates a series of significant features about processes of care-related decision making,
and the ways in which they may empower, inhibit or deny
the perspective of the care-receiver. Such concerns have been
at the heart of person-centred care. As they seek to show, the
notion of epistemic injustice is a helpful way of unpacking why
questions of knowledge sit at the heart of any such project, and
attention to them is an important part of making good on its
Period26 Mar 2019
Held atUniversity of West London, United Kingdom
Degree of RecognitionInternational


  • Co-production Shared Person-centred