Medical misogyny: understanding epistemic injustice to achieve safer healthcare for women in the UK.

Abstract

Since 2019, numerous reports (both official and charity-led) have been published detailing patient care and safety failings in areas of women's healthcare in hospitals across the UK. A common theme that has emerged from these reports is a sense that the voices of women and people seeking maternity care and/or treatment for female health conditions are frequently dismissed and silenced. While many of the examples detailed in these reports have been appropriately recognized as both individual and systemic failings in patient care, here we apply Miranda Fricker's epistemic injustice framework to these issues. We argue that testimonial injustice (a form of discriminatory epistemic injustice) forms a core part of the experience of some of these patients' care resulting in a compounding of their experience of harm. Despite various exhortations within the reports that women should be listened to, the evidence demonstrates that women's testimonial knowledge is systematically devalued. We thus contend that a fundamental reframing of the issue is required and that understanding how and why epistemic injustice occurs is critical to developing a better understanding of how to avoid it, both in the provision of women's healthcare and in its regulation.