The Harm of Ableism: Medical Error and Epistemic Injustice

Area of Science:

• Social Epistemology
• Medical Ethics
• Health Disparities

Background:

• Medical error literature often overlooks biases.
• Group- and identity-based biases contribute to medical errors.
• Marginalized groups, especially disabled patients, are disproportionately affected.

Purpose of the Study:

• To analyze how epistemic errors, particularly those stemming from ableism, contribute to medical errors.
• To explore the mechanisms of ableism in physician-patient communication.
• To advocate for justice-based solutions to schema-based medical errors.

Main Methods:

• Literature review of medical error taxonomies.
• Application of social epistemology concepts.
• Case study analysis of ableism in healthcare interactions.

Main Results:

• Ableism operates through four mechanisms: testimonial injustice, epistemic overconfidence, epistemic erasure, and epistemic derailing.
• These mechanisms distort communication between physicians and disabled patients.
• Epistemic errors rooted in ableism lead to disproportionate medical errors for disabled individuals.

Conclusions:

• Addressing epistemic injustices and schema-based medical errors is a matter of justice.
• Healthcare practice must integrate measures against ableism and other identity-based biases.
• Improved healthcare equity requires tackling the root causes of medical errors in marginalized communities.