Epistemic Injustice within Healthcare: Minoritizes

Scenic Mosley, Dr. Tschaepe, Ph.D.

Department of Political Science, Prairie View A&M University, Prairie View, Texas 77446

Abstract

My initial findings in the Spring of 2019 portrayed the need for more adequate resources to assist patients with linguistic or educational barriers in understanding their diagnosis and/or physical examinations. The epistemic insufficiencies raised as related to law and healthcare are directly connected to the continued research necessary to configure sufficient solutions. Approximately 58 percent of Waller County residents belong to a racial minoritized group. This research argues that the two types of epistemic injustice accounted by Miranda Fricker, hermeneutical and testimonial, adversely affect Waller County’s minoritized persons in healthcare institutions. Epistemic entitlement prevails within these institutions due to sophisticated preparation and comprehension of matters concerning health required by physicians, but not the average minoritized person.

Objective

To understand whether or not the citizens of Waller County have been provided the epistemic resources to make decisions for themselves regarding their health. To develop a comprehensive delivery of medical information to healthcare patients in Waller county and to ensure that patients are given informed consent and proper legal representation. Sub-objectives include: • Provide a thorough review of potential remedies to insufficient medical delivery. • Determine if Informed Consent has been supplied and if Medical Information Therapy is necessary in special cases, such as to those patients who possess educational or linguistic barriers. • Determine if adequate legal representation within healthcare facilities exists. • Assess what the various legal resources are within

Waller county pertaining to medically related lawsuits.

Acknowledgements

R&I’s Office of Undergraduate Research (OUR), Prairie View A&M University

Hypothesis

I subsequently suggest that remedies for deconstructing such epistemic injustices include an approach that focuses specifically on the large range of factors affecting minoritized persons perspectives and lived experiences as a whole, rather than in objectified parts.

Hermeneutical Injustice

Characterized by an individual or patient, not having the resources to explain or understand in thorough detail the experience that they are presently facing. Those who have attained a more powerful position through education, racial or ethnic identity, and socioeconomic status have also established superior understandings of their experiences.

Hence, when given a platform (such as that provided when doctor interviews a patient), these persons are equipped with knowledge to articulate their experience and receive proper care. Alternatively, those lacking in articulation are rendered voiceless. Testimonial Injustice

Characterized by an individual, or patient, being silenced by another person who typically has the ability to (regardless as to whether or not they use this ability) aid in the development of the testimony giver’s agenda or desired outcome.

In this case, a healthcare professional would presumably be able to offer the patient the best treatment or care but is unwilling to listen to the patient’s testimony long enough to establish a consensual patient-doctor relationship where each party has an equal comprehension of the treatment plan to be followed.

Acknowledgements R&I’s Office of Undergraduate Research (OUR) and Political Science Department,, Prairie View A&M University

Results

Figure 1 represents the percentage of law offices that supply their clients with resources to help them understand their medical-legal rights. Figure 2 represents the percentage of law offices that provide their clients with translation services. Figure 3 represents types of law that lawyers specialize in. Figure 4 represents the percentage of Health Clinics that provide information to their patients regarding their medical-legal rights. Figure 5 represents the percentage of Health Clinics that would like additional resources to help their patients understand their diagnoses/physical exams.

Methods

The study consists of the 5 cities within Waller County; Reference Brookshire, Hempstead, Prairie View, Pattison, and a small section of Katy. Thorough interviews with the local healthcare facilities and law office representatives were conducted, and research on Miranda Fricker’s Epistemic Injustice were included and expounded on.

Future Research

The next step is to conduct a study on how to create programs that encourage minoritized persons to become more educated within healthcare matters to the point in which they would be labeled an “insider-outsider” is another solution to bridging the epistemic gaps.

References

Data USA. 2019. “Waller County, TX.” Data USA. Accessed February 3, 2019. https://datausa.io/profile/geo/waller-county-tx/ Towncharts. 2019. “Waller County, Texas Education Data.” TownCharts. Accessed February 3, 2019. http://www.towncharts.com/Texas/Education/WallerCounty-TX-Education-data.html National Center for Medical Legal Partnership. “About Medical-Legal Partnership.” Milken Institute School of Public Health. Accessed February 3, 2019. https://medical-legalpartnership.org/faq/ Mitchell, D J. “Toward a definition of Information Therapy” Proceedings. Symposium on Computer Applications in Medical Care (1994): 71-5.

Introduction

My initial findings in the Spring of 2019 portrayed the need for more adequate resources to assist patients with linguistic or educational barriers in understanding their diagnosis and/or physical examinations. The epistemic insufficiencies raised as related to law and healthcare are directly connected to the continued research necessary to configure sufficient solutions. Approximately 58 percent of Waller County residents belong to a racial minoritized group. This research argues that the two types of epistemic injustice accounted by Miranda Fricker, hermeneutical, and testimonial, adversely affect Waller County’s minoritized persons in healthcare institutions. Epistemic entitlement prevails within these institutions due to sophisticated preparation and comprehension of matters concerning health required by physicians, but not the average minoritized person. Such entitlement and asymmetric attainment of knowledge arguably lead to presumptive attribution of minoritized persons and their experience, which is largely in part responsible for discernable resource disparities.

Materials and Methods

The study consists of the five cities within Waller County; Brookshire, Hempstead, Prairie View, Pattison, and a small section of Katy. Through interviews with the local healthcare facilities and law, office representatives were conducted to gather the information necessary. The questions focused on client and patient informed consent and legal representation in healthcare facilities specifically.

Results and Discussion

Figure 1: represents the percentage of law offices that supply their clients with resources to help them understand their medical-legal rights. Figure 2: represents the percentage of law offices that provide their clients with translation services.

Figure 3: represents types of law that lawyers specialize in.

Figure 4: represents the percentage of Health Clinics that provide information to their patients regarding their medical-legal rights.

Figure 5: represents the percentage of Health Clinics that would like additional resources to help their patients understand their diagnoses/physical exams.

Conclusion

After performing a meta-synthesis literature review, I found that there is a critical need for additional legal resources and representation accessible to stakeholders in the region. Planned future research includes conducting a study on how to bring Informed Consent remedies such as Information Therapy and Medical-Legal Partnerships into Healthcare facilities and Law Offices in Waller County to potentially solve the issues addressed in the hypothesis. Miranda Fricker’s theories of hermeneutical and testimonial injustice apply to minoritized persons in general and in Waller County, because of the heavy burden they bear by not being able to properly advocate for themselves in healthcare facilities. Like the speakers, minoritized persons have been silenced, and the hearers have taken away their testimonies by being unwilling to listen. The hermeneutical devices necessary to even explain their symptoms or ask questions in relation to their diagnosis and/or physical examinations is also lacking, and there needs to be more resources available to properly educate minoritized persons about their health literacy. This information and my concluded findings are relevant to the United States at large and Waller County specifically.

References

1. Data USA. 2019. “Waller County, TX.” Data USA. Accessed February 3, 2019. https://datausa.io/profile/ geo/waller-county-tx/ 2. Towncharts. 2019. “Waller County, Texas Education Data.” TownCharts. Accessed February 3, 2019. http:// www.towncharts.com/Texas/Education/Waller-CountyTX-Education-data.html 3. National Center for Medical-Legal Partnership. “About Medical-Legal Partnership.” Milken Institute School of Public Health. Accessed February 3, 2019. https:// medical-legalpartnership.org/faq/ 4. Mitchell, D J. “Toward a definition of Information Therapy” Proceedings. Symposium on Computer Applications in Medical Care (1994): 71-5.

Scenic Mosley is a Junior majoring in Political Science with a minor in Legal Studies. Dr. Tschaepe is a Professor of Philosophy with research interests in Ethics and Critical Thinking