Clinical Legibility: Recognition Infrastructure in Nursing

Clinical recognition is not produced by nursing judgment alone. Building on Fricker's account of epistemic injustice and extending critical theories of legibility, classification, measurement, and the clinical gaze, this article advances clinical legibility as a foundational theoretical construct for nursing. Clinical legibility names the structural condition under which patient testimony, bodily signs, and nursing concern can be captured, recognized, documented, transmitted, and acted upon equitably across populations. It shifts recognition from the individual knower's mind to the infrastructures that make patient reality actionable, distinguishing clinical legibility from epistemic injustice, implicit bias, structural bias, diagnostic error, and failure to rescue through its focus on the prior problem of recognizability. Three interlocking conditions structure clinical legibility: instruments that produce valid inferences across patient populations, educational repertoires adequate to diverse bodies and presentations, and documentation and escalation systems capable of preserving patient testimony and nursing concern as actionable knowledge. For nursing, clinical legibility clarifies how surveillance, documentation, advocacy, escalation, and care all depend on recognition infrastructure capable of holding patient reality. Reforming that infrastructure is not peripheral to nursing's disciplinary project; it is a condition of ethical care and a disciplinary obligation.