Aesthetic injustice in healthcare: exploring testimonial and hermeneutical forms

This paper introduces and develops the concepts of aesthetic testimonial injustice and aesthetic hermeneutical injustice, arguing that understanding the aesthetic dimensions of human experience, specifically those concerning physical appearance, is central to justice in healthcare practice. Drawing on Miranda Fricker's framework of epistemic injustice, the paper provides a bridge between emerging literature on aesthetic injustice, which is often focused on lookism and appearance-based discrimination, and accounts that emphasize the recognition of individuals as aesthetic subjects. The concept of aesthetic testimonial injustice relates to the unjust discrediting of a person's aesthetic testimony regarding their own body, often due to biases related to attractiveness, age or disability. Aesthetic hermeneutical injustice, by contrast, pertains to the structural disadvantage faced by individuals who lack the interpretive resources to make sense of or communicate their aesthetic experience as it pertains to bodily appearance, particularly in healthcare contexts. Using examples from prosthetics design, nursing care and disorders of visual perception, the paper shows how healthcare systems can marginalize patients' aesthetic values and perceptions, thereby undermining their dignity and agency. It concludes by calling for a deeper understanding of aesthetics in bioethics, suggesting that respecting patients as embodied aesthetic agents can enhance ethical healthcare delivery and counter systemic injustice. The concepts of aesthetic testimonial injustice and aesthetic hermeneutical injustice thus expand bioethical discourse by highlighting the moral significance of aesthetic experience in healthcare contexts.