A ‘major’ new six-year study will use philosophical expertise to help bring patient voices into healthcare research and practice.
Researchers at the University of Nottingham, University of Bristol, and University of Birmingham, have received a £2.6 m Wellcome Discovery Grant for the 'Epistemic Injustice in Healthcare (EPIC)’ project, which will use philosophical expertise to explore forms of 'silencing'. The researchers said: “Patients regularly report that their testimonies and perspectives are ignored, dismissed, or explained away by the healthcare profession. These experiences are injustices because they are unfair and harmful –and philosophers call them ‘epistemic injustices’ because they jeopardise patient care and undermine trust in healthcare staff and systems.”
By studying these epistemic injustices, the researchers say EPIC will ‘find ways to correct them and improve the relationship between patients and healthcare practitioners’. The EPIC team has internationally recognised expertise in philosophy, psychiatry, and law. Principal Investigator, Professor Havi Carel, from the University of Bristol, is an authority on philosophy and phenomenology of illness.
EPIC will provide what is claimed to be the first systematic study of epistemic injustice across a range of healthcare settings, and the first to offer a set of empirical studies that will show how and when epistemic injustice appears. It will also be the first funded project to seek ways to overcome epistemic injustice. Professor Havi Carel, Principal investigator, University of Bristol (pictured), will be joined by fellow Bristol academic, Professor Sheelagh McGuinness, an authority on health, gender, and the law, while Dr Ian James Kidd, Assistant Professor in Philosophy, will lead the research at the University of Nottingham. Dr Kidd, an epistemologist and philosopher of illness, pioneered the study of epistemic injustices in healthcare with Professor Carel.
The University of Birmingham team, meanwhile, is led by Professor Lisa Bortolotti, a philosopher of psychiatry, and editor of the Philosophical Psychology journal, and Professor Matthew Broome, an academic NHS psychiatrist and director of the Birmingham Institute for Mental Health. Commenting on the study, Professor Bortolotti said: "It is especially important for people with a mental health diagnosis to contribute to shared knowledge concerning their symptoms and treatment. This study will challenge the assumption that they are irrational or disconnected from reality, and so not worthy of being listened to."
The researchers say that patients ‘have long reported feeling ignored, dismissed, or silenced in ways that jeopardise their care and intensify their suffering’. They said: “The challenge is to understand how this silencing happens, and what can be done about it, in ways that can help patients and healthcare practitioners alike. The NHS is right to seek patient perspectives, and listen to patient voices. Project EPIC will help them to do that better by fully diagnosing the causes of that silencing.”
The EPIC team will be completed by eight postdoctoral researchers and a range of other researchers and collaborators from Swansea, City, and Aston Universities, as well as the Universities of Bologna and Ferrara in Italy, making a team of around 30 researchers.
The six case studies that form part of the research will focus on labour pain, child mental health, neurodiversity, cancer, depression, and later-life care.