Patient-centered or population-centered? How epistemic discrepancies cause harm and sow mistrust

Katie Donnelly

Social Science & Medicine, 2024, vol. 341, issue C

Abstract: Medical distrust is often conceived of as a problem of misinformation or ignorance. In this paper, I depart from this framework, attributing distrust instead to epistemic divergence between lay people and experts. Using data from a contraceptive side effects Facebook group and in-depth physician interviews, I find that providers employ a “body-as-subject” lens informed by population-health goals, while group members employ a “body-as-agent” lens that privileges individuality and bodily autonomy. Provider epistemologies are privileged, creating epistemic injustice and harm for patients. Ultimately, this erodes trust in providers and the medical community more broadly.

Keywords: Medical distrust; Epistemic injustice; Doctor-patient interactions; Online health community; Women's health; Reproductive health; Contraception (search for similar items in EconPapers)
Date: 2024
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DOI: 10.1016/j.socscimed.2023.116552

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