Miss Stephanie Cameron1,2, Professor Katrien Devolder2, Professor Justin Oakley3
1Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia, 2Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom, 3Monash Bioethics Centre, Monash University, Melbourne, Australia
Biography:
Stephanie Cameron is a final year medical student at Monash University. In 2023, she completed a BMedSc(Hons) in Bioethics at the Oxford Uehiro Centre for Practical Ethics under the supervision of Professor Justin Oakley and Professor Katrien Devolder. Her current research focuses on Epistemic Injustice in the Context of Difficult-to-Diagnose Medical Conditions.
Abstract:
Epistemic injustice frequently occurs in healthcare encounters involving difficult-to-diagnose conditions, such as long COVID, myalgic encephalomyelitis/chronic fatigue syndrome, fibromyalgia, and endometriosis. In this paper, we argue that physicians have a crucial role in cultivating virtuous dispositions to promote epistemically just healthcare encounters in the context of difficult-to-diagnose conditions. Drawing on Miranda Fricker’s theory of epistemic injustice, we first explain why epistemic injustice occurs in the context of difficult-to-diagnose conditions. We then identify several implicit cognitive biases that impede physicians’ attempts to achieve epistemic justice, including implicit negative stereotyping, visceral bias, the fundamental attribution error, and the Dunning-Kruger effect. To counter these biases, we argue that physicians should engage with targeted strategies, and emphasise the need for ‘virtue-conducive environments’ to support individual critical reflection. We conclude by proposing evidence-based practical strategies in medical education designed to address key biases and cultivate virtues that serve patients’ interests in being heard and understood. These strategies include enhancing teaching on difficult-to-diagnose conditions and integrating cognitive debiasing strategies into medical curricula.