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Diagnostic Overshadowing in Psychiatric-Somatic Comorbidity: A Case for Structural Testimonial Injustice

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Diagnostic Overshadowing in Psychiatric-Somatic Comorbidity : A Case for Structural Testimonial Injustice. / Bueter, Anke.

In: Erkenntnis: An International Journal of Scientific Philosophy, 02.05.2021.

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Bueter, Anke. / Diagnostic Overshadowing in Psychiatric-Somatic Comorbidity : A Case for Structural Testimonial Injustice. In: Erkenntnis: An International Journal of Scientific Philosophy. 2021.

Bibtex

@article{10830c133cd246f7bf64a2d2ee633725,
title = "Diagnostic Overshadowing in Psychiatric-Somatic Comorbidity: A Case for Structural Testimonial Injustice",
abstract = "People with mental illnesses have higher prevalence and mortality rates with regard to common somatic diseases and causes of death, such as cardio-vascular conditions or cancer. One factor contributing to this excess morbidity and mortality is the sub-standard level of physical healthcare offered to the mentally ill. In particular, they are often subject to diagnostic overshadowing: a tendency to attribute physical symptoms to a pre-existing diagnosis of mental illness. This might be seen as an unfortunate instance of epistemic bad luck, where particular features of a group of patients make a timely and correct diagnosis unlikely. While this can explain some cases of diagnostic overshadowing, I argue that in other cases, epistemic injustice is involved. Analyzing the case of diagnostic overshadowing, I distinguish two kinds of testimonial injustice. For one, there are classic cases of transactional testimonial injustice resulting from prejudices against the mentally ill. In addition, there are cases of structural testimonial injustice resulting from features of health care systems. To overcome diagnostic overshadowing, remedies on the individual as well as structural level are thus needed.",
author = "Anke Bueter",
year = "2021",
month = may,
day = "2",
doi = "10.1007/s10670-021-00396-8",
language = "English",
journal = "Erkenntnis: An International Journal of Scientific Philosophy",
issn = "0165-0106",
publisher = "Springer",

}

RIS

TY - JOUR

T1 - Diagnostic Overshadowing in Psychiatric-Somatic Comorbidity

T2 - A Case for Structural Testimonial Injustice

AU - Bueter, Anke

PY - 2021/5/2

Y1 - 2021/5/2

N2 - People with mental illnesses have higher prevalence and mortality rates with regard to common somatic diseases and causes of death, such as cardio-vascular conditions or cancer. One factor contributing to this excess morbidity and mortality is the sub-standard level of physical healthcare offered to the mentally ill. In particular, they are often subject to diagnostic overshadowing: a tendency to attribute physical symptoms to a pre-existing diagnosis of mental illness. This might be seen as an unfortunate instance of epistemic bad luck, where particular features of a group of patients make a timely and correct diagnosis unlikely. While this can explain some cases of diagnostic overshadowing, I argue that in other cases, epistemic injustice is involved. Analyzing the case of diagnostic overshadowing, I distinguish two kinds of testimonial injustice. For one, there are classic cases of transactional testimonial injustice resulting from prejudices against the mentally ill. In addition, there are cases of structural testimonial injustice resulting from features of health care systems. To overcome diagnostic overshadowing, remedies on the individual as well as structural level are thus needed.

AB - People with mental illnesses have higher prevalence and mortality rates with regard to common somatic diseases and causes of death, such as cardio-vascular conditions or cancer. One factor contributing to this excess morbidity and mortality is the sub-standard level of physical healthcare offered to the mentally ill. In particular, they are often subject to diagnostic overshadowing: a tendency to attribute physical symptoms to a pre-existing diagnosis of mental illness. This might be seen as an unfortunate instance of epistemic bad luck, where particular features of a group of patients make a timely and correct diagnosis unlikely. While this can explain some cases of diagnostic overshadowing, I argue that in other cases, epistemic injustice is involved. Analyzing the case of diagnostic overshadowing, I distinguish two kinds of testimonial injustice. For one, there are classic cases of transactional testimonial injustice resulting from prejudices against the mentally ill. In addition, there are cases of structural testimonial injustice resulting from features of health care systems. To overcome diagnostic overshadowing, remedies on the individual as well as structural level are thus needed.

U2 - 10.1007/s10670-021-00396-8

DO - 10.1007/s10670-021-00396-8

M3 - Journal article

JO - Erkenntnis: An International Journal of Scientific Philosophy

JF - Erkenntnis: An International Journal of Scientific Philosophy

SN - 0165-0106

ER -