Scientific article
Open access

Epistemic Injustice and Nonmaleficence

ContributorsDella Croce, Yoannorcid
Published inJournal of Bioethical Inquiry, p. 10 p.
Publication date2023-06-28
First online date2023-06-28


Epistemic injustice has undergone a steady growth in the medical ethics literature throughout the last decade as many ethicists have found it to be a powerful tool for describing and assessing morally problematic situations in healthcare. However, surprisingly scarce attention has been devoted to how epistemic injustice relates to physicians’ professional duties on a conceptual level. I argue that epistemic injustice, specifically testimonial, collides with physicians’ duty of nonmaleficence and should thus be actively fought against in healthcare encounters on the ground of professional conduct. I do so by fleshing out how Fricker’s conception of testimonial injustice conflicts with the duty of nonmaleficence as defined in Beauchamp and Childress on theoretical grounds. From there, I argue that testimonial injustice produces two distinct types of harm, epistemic and non-epistemic. Epistemic harms are harms inflicted by the physician to the patient qua knower, whereas non-epistemic harms are inflicted to the patient qua patient. This latter case holds serious clinical implications and represent a failure of the process of due care on the part of the physician. I illustrate this through examples taken from the literature on fibromyalgia syndrome and show how testimonial injustice causes wrongful harm to patients, making it maleficent practice. Finally, I conclude on why nonmaleficence as a principle will not be normatively enough to fully address the problem of epistemic injustice in healthcare but nevertheless may serve as a good starting point in attempting to do so.

  • Epistemic injustice
  • Fibromyalgia
  • Harm
  • Nonmaleficence
Citation (ISO format)
DELLA CROCE, Yoann. Epistemic Injustice and Nonmaleficence. In: Journal of Bioethical Inquiry, 2023, p. 10 p. doi: 10.1007/s11673-023-10273-4
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Article (Published version)
ISSN of the journal1176-7529

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