认知不公正的时间方面:药物依赖患者的案例。

IF 1.8 3区 哲学 Q2 ETHICS Journal of Bioethical Inquiry Pub Date : 2025-01-06 DOI:10.1007/s11673-024-10404-5
Sergei Shevchenko, Alexey Zhavoronkov
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引用次数: 0

摘要

学者通常区分证词和解释性认识不公正在医疗保健。前者源于负面的刻板印象和污名化,而后者则发生在主导社区的解释学资源不足以阐明一个人的疾病经历时。然而,这两种类型的认知困境提供的启发式往往忽略了认知不公正的显著形式。在本文中,我们以药物依赖患者的暂时性为例证明了这一论点。我们确定了影响药物依赖患者的认知不公正的三个时间维度:他们的认知过程的时间特征,他们的个人时间经验,以及社会时间的不匹配。值得注意的是,最后一个方面强调了护理的可获得性和可获得性之间的差距,并不完全适合证言或解释学上的不公正。(我们应该注意到,国际吸毒人员网络(INPUD)和亚洲吸毒人员网络(ANPUD)认为“吸毒成瘾”一词与剥夺权力和负面刻板印象有关。相反,他们建议使用“药物依赖”(INPUD 2020)一词。然而,“药物成瘾”的概念仍然被用于当前涉及成瘾研究特定领域的公共卫生、哲学和社会学辩论中。用“药物依赖”取代药物成瘾的概念不会消除现有的认知不公正,也不会让我们避免创造新的不公正,比如那些与忽视疼痛声称有关的不公正(O'Brien 2011)。尽管如此,为了清楚起见,我们在谈到人时将使用“药物依赖”的概念,同时保留“药物成瘾”一词来标记医疗保健实践和医疗保健哲学的主题。)
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Temporal Aspects of Epistemic Injustice: The Case of Patients with Drug Dependence.

Scholars usually distinguish between testimonial and hermeneutical epistemic injustice in healthcare. The former arises from negative stereotyping and stigmatization, while the latter occurs when the hermeneutical resources of the dominant community are inadequate for articulating the experience of one's illness. However, the heuristics provided by these two types of epistemic predicaments tend to overlook salient forms of epistemic injustice. In this paper, we prove this argument on the example of the temporality of patients with drug dependence. We identify three temporal dimensions of epistemic injustice affecting drug-dependent patients: the temporal features of their cognitive processes, their individual temporal experience, and the mismatch of social temporality. Notably, the last aspect, which highlights the disparity between the availability of care and its accessibility, does not fit neatly into the categories of testimonial or hermeneutical injustice. (We should note that the International Network of People Who Use Drugs (INPUD) and The Asian Network of People who use Drugs (ANPUD) consider the term "drug addiction" to be associated with disempowerment and negative stereotyping. Instead, they suggest the expression "drug dependence" (INPUD 2020). However, the concept of "drug addiction" is still being used in the current public health, philosophy, and sociology debates that concern the specific field of addiction studies. Replacing the notion of drug addiction with "drug dependence" would not eliminate existing epistemic injustices or allow us to avoid creating new ones, such as those related to ignoring pain claims (O'Brien 2011). Still, for the sake of clarity we will use the notion "drug dependence" when speaking of people while retaining the term "drug addiction" for labelling healthcare practices and the topic for philosophy of healthcare.).

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来源期刊
Journal of Bioethical Inquiry
Journal of Bioethical Inquiry 医学-医学:伦理
CiteScore
5.20
自引率
8.30%
发文量
67
审稿时长
>12 weeks
期刊介绍: The JBI welcomes both reports of empirical research and articles that increase theoretical understanding of medicine and health care, the health professions and the biological sciences. The JBI is also open to critical reflections on medicine and conventional bioethics, the nature of health, illness and disability, the sources of ethics, the nature of ethical communities, and possible implications of new developments in science and technology for social and cultural life and human identity. We welcome contributions from perspectives that are less commonly published in existing journals in the field and reports of empirical research studies using both qualitative and quantitative methodologies. The JBI accepts contributions from authors working in or across disciplines including – but not limited to – the following: -philosophy- bioethics- economics- social theory- law- public health and epidemiology- anthropology- psychology- feminism- gay and lesbian studies- linguistics and discourse analysis- cultural studies- disability studies- history- literature and literary studies- environmental sciences- theology and religious studies
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