Send message to Author

Paper short abstract

This paper aims to fill a gap in the literature by positioning epistemic injustice in participation issues with disease metaphysics to help patients shape the meaning of the concept of disease in their own disease process.

Paper long abstract

Patients can now engage in various levels and stages of medical decision-making, the limitations of existing participation models have become a critical area of study. Within frameworks analyzing obstacles to participation, patients’ self-definition in the individual conceptualization of disease remains a neglected issue. The paper problematizes epistemic aspects of participation within disease metaphysics, about epistemic injustice, and linguistic division of labor. While the standard view of disease acknowledges patients’ expertise in relation to the concept of disease, this involvement is limited to shaping the concept of illness, which holds a translational relationship to disease. In this translational relationship, illness needs to be translated into the “expert” language that is built around disease and biomedical vocabulary. In this framework, illness is reserved for personal meaning and notion. I will support the linguistic and epistemic claim metaphysically through evolutionary medicine. At the metaphysical level, evolutionary medicine posits that what humans have evolved is disease vulnerability, not disease itself per se. This perspective offers a research program that reimagines metaphysics of disease. I will connect this to, recent work in the philosophy of medicine that argues, health can be considered a secondary property, similar to disease vulnerability being prior to disease instances. By combining these two perspectives; the primacy of disease vulnerability in evolutionary medicine and the notion of disease as a secondary property, the concept of disease can be epistemicly reconstructed to enable patient participation within epistemic division of labor.