Epistemic Injustice and Psychiatric Service Users: The Denial of Capacity as a Special Epistemic Harm

In this paper, I consider a group of patients that is often taken to be incapable of providing legitimate informed consent - populations with psychiatric disorders. I suggest this view is misguided using the philosophical tools of standpoint theory and epistemic injustice. Given that psychiatric patients are members of socially marginalized groups, standpoint theory would suggest that they are socially situated in ways that give them privileged epistemic access to relevant features of their worlds relative to the non-marginalized. Standpoint theory explains why patients like these have a particular perspective that enables them to see important elements of their experience that others do not. Epistemic injustice, on the other hand, enables us to see not only how and why these patients have special epistemic standing, but the ways in which this standing is systematically ignored. This disregard can then ultimately lead to injustice in the treatment of psychiatric service users.