Epistemic Injustice in Healthcare : the potential for Hermeneutical Injustice within South Africa's Primary Healthcare System

Abstract

This dissertation demonstrates that philosophical analysis has real-world applications. Although written in the field of political epistemology, the dissertation engages with knowledge representation and reasoning (KRR) in artificial intelligence (AI) in so far as it focuses on identifying and eliminating obstacles in knowledge acquisition, representation, and communication. The dissertation focuses specifically on the concept of epistemic injustice. The concept, as coined by Miranda Fricker, refers to a kind of injustice that causes a knower to be undermined in their capacity to give, receive, or understand knowledge. Epistemic injustice is critically discussed in the dissertation and also expanded upon, seeing as Fricker does not address all forms of epistemic injustice in all contexts within which this kind of injustice may arise. I analyse the concept of epistemic injustice within the specific context of structural inequalities in healthcare in South Africa. To do this, I identify and analyse conceptions of epistemic injustice that can be applied in this context, in the forms of hermeneutic, contributory and documental injustice. I then consider the recent Life Esidimeni tragedy in South African mental healthcare in the context of these kinds of injustice. Lastly, I present an analysis of virtue epistemology, and construct a virtue of epistemic justice that is richer than Fricker’s, as a measure to combat epistemic injustice in the context of healthcare in South Africa.