Diagnostic injustice. What is it, what are its sources, and what can we do about it?

Although the issue of injustice in healthcare has been extensively discussed-particularly in relation to access to treatments-diagnostic injustice remains insufficiently addressed. Therefore, it is crucial to clarify the concept of diagnostic injustice, identify its underlying sources, and explore potential solutions to mitigate its impact.

An ethical analysis of diagnostics reveals that diagnostic injustice manifests in various traditional forms of injustice, including distributive, procedural, social, structural, systemic, and epistemic injustice. A subsequent narrative review identifies various sources of diagnostic injustice, such as unclear diagnostic criteria, arbitrary diagnostics, unfair taxonomic processes, biomedical (technological) dominance, uncertainty, prejudice, stereotypes, biases, as well as diagnostic hierarchies. Corresponding to these sources of diagnostic injustice, a range of measures are proposed to mitigate its effects.

Diagnostic injustice is pervasive and rooted in a complex array of sources tied to social and professional norms and values, making it challenging to effectively mitigate. By clarifying the concept, pinpointing its sources, and recommending measures to manage diagnostic injustice, this article highlights the importance of promoting diagnostic justice in healthcare.

Diagnostic injustice is an understudied topic that deserves more attention. This study defines the concept, identifies its sources, and suggests measures to mitigate its effects. As such it is the first step to address diagnostic injustice and to enhance the equity in healthcare. Future work should focus on developing and implementing effective interventions that target the identified sources of injustice, ultimately striving for a more just healthcare system.