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Epistemic Injustice
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Epistemic Injustice

the wider social and cultural context in which the disease

they are expected to prevent or control originated.
AIDS; Bioterrorism; Care; Community and
Communitarianism; Human Rights; Literature and
Health Care; Narrative; Pandemics; Public Health: I.
History; Public Health: III. Philosophy; Public Health:
IV. Ethics; Vaccination and Immunization

SEE ALSO

BIBLIOGRAPHY

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eds. 1988. Peurs et terreurs face la contagion: Cholera,
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Instability in a Complex Global System. Journal of Medicine
and Philosophy 27 (2): 16377.
Brandt, Allan M. 1987. No Magic Bullet: A Social History of
Venereal Disease in the United States since 1880, expanded ed.
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Cliff, Andrew; Peter Haggett; and Matthew Smallman-Raynor.
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the Disease Records of World Cities, 18881912. New York:
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Crosby, Alfred W. 1972. The Columbian Exchange: Biological and
Cultural Consequences of 1492. Westport, CT: Greenwood Press.
Delumeau, Jean. 1990. Sin and Fear: The Emergence of a Western
Guilt Culture, 13th18th Centuries. Translated by Eric
Nicholson. New York: St. Martins Press.
Dubos, Ren, and Jean Dubos. 1987. The White Plague:
Tuberculosis, Man and Society. New Brunswick, NJ: Rutgers
University Press.
Durey, Michael. 1979. The Return of the Plague: British Society and
the Cholera, 18312. Dublin: Gill & Macmillan.
Evans, Richard J. 1987. Death in Hamburg: Society and Politics in
the Cholera Years 18301910. Oxford: Clarendon Press.
Evans, Richard J. 1988. Epidemics and Revolutions: Cholera
in Nineteenth-Century Europe. Past and Present 120 (1):
12346.
Frieden, Nancy M. 1977. The Russian Cholera Epidemic, 1892
93, and Medical Professionalization. Journal of Social History
10 (4): 53859.
Gayle, Helene. 2000. An Overview of the Global HIV/AIDS
Epidemic, with a Focus on the United States. AIDS 14
(suppl. 2): S817.
Gostin, Lawrence O.; John W. Ward; and A. Cornelius Baker.
1997. National HIV Case Reporting for the United States: A
Defining Moment in the History of the Epidemic. New
England Journal of Medicine 337 (16): 116267.

Hays, J. N. 1998. The Burdens of Disease: Epidemics and Human

Response in Western History. Piscataway, NJ: Rutgers University
Press.
Henze, Charlotte. 2009. Disease, Health Care and Government in
Late Imperial Russia. London: Taylor and Francis.
Kiple, Kenneth F. 1984. The Caribbean Slave: A Biological History.
Cambridge, UK: Cambridge University Press.
Kiple, Kenneth F., ed. 1993. The Cambridge World History of
Human Disease. Cambridge, UK: Cambridge University Press.
Lachmann, Peter J. 1998. Public Health and Bioethics. Journal
of Medicine and Philosophy 23 (3): 297302.
Lederberg, Joshua. 2000. Infectious History. Science 288
(5464): 28793.
Markel, Howard. 1999. Quarantine!: East European Jewish
Immigrants and the New York City Epidemics of 1892.
Baltimore, MD: Johns Hopkins University Press.
McNeill, William H. 1979. Plagues and Peoples. Harmondsworth,
UK: Penguin.
Oldstone, Michael B. A. 1998. Viruses, Plagues, and History.
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Oshinsky, David M. 2005. Polio: An American Story. New York:
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Porter, Dorothy. 1993. Public Health. In Companion Encyclopedia of the History of Medicine, Vol. 2, edited by William F.
Bynum and Roy Porter, 123161. New York: Routledge.
Rosen, George. 1974. From Medical Police to Social Medicine:
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Rosenberg, Charles E. 1992. Explaining Epidemics and Other
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University Press.
Slack, Paul. 2012. Plague: A Very Short Introduction. New York:
Oxford University Press.
Tuohey, John F. 1995. Moving from Autonomy to Responsibility in HIV-Related Healthcare. Cambridge Quarterly of
Healthcare Ethics 4 (1): 6470.
van Niekerk, Anton A. 2002. Moral and Social Complexities of
AIDS in Africa. Journal of Medicine and Philosophy 27 (2):
14362.
Vasold, Manfred. 1991. Pest, Not und schwere Plagen: Seuchen und
Epidemien von Mittelalter bis heute. Munich: C. H. Beck.
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Richard J. Evans (1995, 2014)
Regius Professor of History, University of Cambridge

Guillemin, Jeanne. 2000. Anthrax: The Investigation of a Deadly

Outbreak. New England Journal of Medicine 343 (16): 1198.

EPISTEMIC INJUSTICE

Harrison, Mark. 2012. Contagion: How Commerce Has Spread

Disease. New Haven, CT: Yale University Press.

Trust in the therapeutic relationship is often taken for

granted partly because health care providers possess a

BIOETHICS, 4TH EDITION

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Epistemic Injustice

substantial body of knowledge in their specialized clinical

domain and presumably have superior cognitive and
intellectual abilities to apply such knowledge and skills to
various health care circumstances compared to their lay
patients. Professionals specialized training and the
resulting epistemological gap due to unequal knowledge
levels give prima facie reasons for patients (who seemingly
cannot adequately assess the evidence in this domain) to
accept the providers clinical judgment.
Nonetheless, many feminist philosophers of science
and epistemologists have increasingly drawn attention to
the communal aspects of knowing and the unjust
distribution of benefits and burdens in such endeavors.
While the notions of respect for patient autonomy and
shared decision making have gained more acceptance in
Western bioethics, members of various social groups
continue to face disparity in access to appropriate and
affordable health care as well as encounter poorer
relationships with their health care providers. Such
perpetual inequality has prompted concerns that some
patient populations may have been unfairly dismissed as
being incredulous in the health care encounters.
As both a moral concept as well as an epistemic
concept, epistemic injustice is a type of wrong and harm
that is done to individuals or social groups regarding their
ability to contribute to and benefit from knowledge
creation. This form of injustice can occur in at least three
interrelated types of scenarios. First, epistemic injustice
can happen in the form of unequal distribution of
hermeneutical resources such as conceptual understanding
and articulative ability that would be necessary to achieve
or contribute to knowledge creation. Second, epistemic
injustice can occur when certain peoples capacity as
knowers or collaborative learners is unfairly dismissed.
Third, epistemic injustice can happen when there is
intermethod hierarchy, that is certain methods of inquiry
or research are uncritically dismissed while other methods
are categorically presumed to be superior. Epistemic
injustice in a health care setting can distort health data,
thwart peoples ability to acquire appropriate care, and
affect therapeutic relationships.
UNEQUAL DISTRIBUTION OF EPISTEMIC
RESOURCES AND OPPORTUNITIES

Epistemic injustice often happens within a larger social or

institutional framework that affords its members unequal
resources and status, leaving some people disadvantaged in
their effort to contribute to or reap benefits from
knowledge creation. Miranda Fricker, for example,
explained in her oft-cited 2007 book that some people
are unfairly excluded from the epistemic community
because of their social backgrounds. First, there are
situations where there is an inequitable distribution of the

1038

resources and opportunities that are necessary for people

to achieve knowledge or co-contribute to the creation of
understanding. Hermeneutical injustice, for example,
occurs when people lack the resources, especially
conceptual resources, to formulate or understand important problems, articulate or communicate their concerns
or experience, or address them systematically. This form
of injustice typically arises in social structures where the
powerful have an unfair advantage in structuring collective
understandings, while the powerless are excluded from
cogenerating or costructuring social meanings of certain
practices because of their social identity. Access to
education, information, and opportunities to engage in
dialogues that form communal meanings of various
practices can affect peoples cognitive confidence, communicative ability, interaction or relationship with others,
and knowledge of the social world. People who lack
hermeneutical resources may be unable to articulate and
illuminate important aspects of their social experiences or
self-understanding.
People with impairments, whose functioning has
been impacted by an injury, illness, or congenital
condition, can serve as an example of this phenomenon.
Prior to the independent living movement and the
development of the social model of disability, the medical
model dominated the way impairments and their impact
on peoples lives were understood. (Some may argue that
this model persists to this day.) While social factors have
significant impact on ones functioning and ability to
participate in various activities, many able-bodied and
able-minded people, including the majority of health care
professionals, adopted the medical model of disability. As
Anita Silvers illustrates in her contribution to a 1998
volume on disability and public policy, this model
assumes that disability results from biophysical impairments that inevitably reduce the individuals quality of life
and opportunities. It focuses on the symptoms of various
conditions rather than on other factors such as sociopolitical and relational frameworks that are often more
important to peoples quality of life. Many with
impairments lived in institutions, had little employment
opportunities, and endured isolation and lonely lives. In
some notable court cases in various jurisdictions, plaintiffs
appealed for the right to assisted death to end what was
often interpreted as unbearable suffering brought on by
their physiological conditions, even when the anguish was
not always well understood by the plaintiffs themselves. In
some of these cases, the plaintiffs only came to recognize
later with the help of other disability activists that their
despair was not the direct consequence of their impairments. Rather, it was the intertwining result of social
disadvantages, isolation, and lack of opportunities brought
on by an ableist society that refuses to accommodate and
support people of various abilities and conditions.
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Epistemic Injustice

TESTIMONIAL INJUSTICE

Epistemic injustice can also occur when someones

assertions or testimonies are not accepted because he or
she is unfairly deemed (by the hearer) as lacking what is
required to be a credible informant. When hearers fail to
gather accessible counterevidence or when they generalize
too quickly from a small sample to form a prejudice
against an individual or individuals qua members of a
social group, they are epistemically culpable for such
identity prejudices. A paradigmatic situation is one where
an individuals testimony is dismissed as categorically less
credible as a result of stereotypes around morally irrelevant
factors such as skin color, gender, sexual orientation,
socioeconomic background, and impairments. Such
prejudice is often systematic, following individuals across
various spectrums of their liveseconomic, educational,
professional, sexual, and so forth.
Culpable prejudice can become a form of testimonial
injustice when the hearer has an obligation to avoid a
credibility deficit. We may not have a general obligation
to match our credibility judgments to the evidence in
every case for every person, even if that may deprive
ourselves of useful information. For example, patients
have no obligation to trust pharmaceutical advertisers
claims regarding the effectiveness or superiority of the
drugs the latter are promoting, even if the advertisers are
telling the truth. However, certain interpersonal or
professional relationships between the speaker and the
hearer call for mutual acknowledgment and understanding of the other persons perspectives. In these situations,
the speaker can rightfully expect the hearer not to
prematurely dismiss his or her claims, especially when
the speaker has a lot at stake in whether his or her
testimony is regarded as credible. In the health care
setting, given that patients are subjecting themselves to
clinicians whose actions can have significant impact on the
patients well-being, the therapeutic relationship demands
that patients claims are given due respect. Testimonial
injustice may occur when patients reports of their
symptoms, experience, or concerns are not believed by
their health care providers because of the patients social
status and other prejudicial reasons. Such injustice can be
particularly problematic when it affects a patients ability
to negotiate or access appropriate care.
Another look at the experience of people with
impairments, particularly in relation to how they have
been systematically considered less credible in disability
and medical discourses compared to perspectives of
medical experts, can shed light on how testimonial
injustice can occur and harm the stakeholders. While
clinicians generally have goodwill toward their patients
and are motivated by the latters interests, people with
impairmentswho have long been subjected to social
exclusion and marginalizationare often seen as globally
BIOETHICS, 4TH EDITION

less credible and less competent. People who experience

difficulties with public transportation because of mobility
impairments as well as chronic fatigue or respiratory
problems may qualify for assistive equipment, accessible
parking permits, home care, or transportation subsidy
upon physician support for such requests. Although welltrained professionals would generally consult their patients
regarding their needs and would assume that patients are
providing a relatively accurate account of their concerns,
the reports and motives of patients may sometimes be
distrusted, especially if reported symptoms such as pain or
fatigue do not have a corresponding and accepted physical
sign. The clinicians presumed epistemic superiority gives
them authority to override patients self-reported experience. The approval process for various services signals that
it is only when a patients claim has been verified by an
objective expert that the validity of the patients claim is
accepted. The sincerity and integrity of claimants are not
presumed. The patients lived experience is not trusted on
its own merit and is insufficient to trump the experts
opiniona petition can be considered frivolous or even
potentially fraudulent until it is confirmed by the experts
assessment.
The issue of testimonial (in)justice is especially
worrisome when patients also have cognitive impairments,
or psychiatric conditions, or both, since health care
professionals may overextend judgments of incapacity and
fail to acknowledge that people might still be capable of
expressing preferences that ought to be honored. Jennifer
Radden (2010) and others point out that these patients
have been traditionally excluded from or misrepresented
by the epistemic as well as the social community, with
their voices being disregarded and dismissed as meaningless or incapable of forming constructive meanings. A
categorical prioritization of experts perspectives or a default
position of distrust in the claimants testimony as irrelevant,
unreliable, or untrustworthy can reinforce the power
differential that already underlies many professionalpatient relationships and exacerbate the social hierarchy.
After all, the credibility gap confers on health care
providers the power to determine what issues are
worthwhile to include in their inquiry, how they are to
be studied, and how challenges or disagreements by
patients who are not part of the epistemic community are
to be handled. Patients who are deemed incredulous by
their health care providers often do not get to decide what
is credible or even who has the appropriate expertise or
authority to make these decisions.
One of the complexities in assessing whether
professionals distrust in a patients testimonial credibility
is a form of epistemic injustice is that such suspicion
may be multifactorial and intersectional. This is particularly the case when clinicians are caring for patients
with a history of addiction, noncompliant behaviors,

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Epistemic Injustice

personality disorders, or other psychiatric conditions.

Stereotypes regarding these patient populations abound,
many of which are discriminatory and further disenfranchise these patients. However, Fricker (2007) and others
have argued that in situations where certain stereotypes
regarding these populations are sometimes helpful in
preventing harm to the patient or others, a clinician who
mistakenly relies on such a stereotype in refusing to
believe a patient of these characteristics may be suffering
from a case of epistemic bad luck rather than testimonial
injustice. For example, a clinician who disbelieves her
patients report of his need for a new prescription to
replace his lost pain medication may suspect that the latter
has diverted his prescription or has become addicted to
the drugs. The clinician, who is concerned about how
the patient might have taken an alarming dosage of
pain medication or sold the prescription to others, may
have legitimate worries about trusting the patients
testimony. She may fear that prescribing more medication
to this patient as requested could harm either her patient
or others who may be receiving the drugs from the
patient.
Certainly, deception and exploitation of the system
can occurthese concerns call for careful management
strategies to prevent harm and to protect the integrity of
the system. It is nonetheless worth noting that many
patients who are distrusted by professionals are often also
disenfranchised on various fronts (e.g., visible minorities),
blurring the line between identity prejudice and experiencebased distrust. Some feminist epistemologists, particularly
those who ascribe to or are influenced by standpoint
theory, argue that silencing those in oppressed positions can
severely compromise our quest for knowledge. Nancy
Hartsock (1987), Hilary Rose (1987), and others point out
that members in disadvantaged groups may in fact have a
privileged view or better understanding of their social
situations and struggles than those who are in dominant
positions and can conveniently ignore and undermine the
interests of subordinates.
Given the inherent power hierarchy between professionals and patients, even unintended epistemic errors can
render some patients unable to contribute to full
exploration of their own conditions or the most
appropriate management strategies. Such error may
prevent patients from asking questions, raising concerns,
floating ideas, considering alternative possibilities, and so
on. People who are routinely not being taken seriously as a
source of information may lose confidence in their ability
or motivation to obtain and transmit knowledge. Patients
who internalize the dismissals and consider themselves
incapable of purveying useful or relevant information may
lose or never build confidence in their ability to make
health care choices that are consistent with their goals and
values. These patients most likely will not ask questions,

1040

seek clarification, engage in treatment planning, or bring

up issues regarding their ability to, say, follow a rigorous
regimen as recommended. As strong therapeutic alliance
often requires mutual trust and respect between health
care providers and patients, premature dismissal of some
patients credibility may thwart even well-meaning
clinicians goals to construct appropriate care plans that
will promote their patients interests.
UNQUESTIONED INTERMETHOD HIERARCHY

Certainly, a call for critical awareness of potential

prejudice and a commitment to correct such prejudice
do not refute the reality that health care providers
generally know much more about the clinical domain
than their lay patients. Under the intramethod notion
of epistemic hierarchy, rankings of credibility can be
assigned by looking at different levels of training or
expertise among people regarding a particular domain.
Within clinical medicine, physicians by virtue of their
intensive education and practice have superior ability to
accurately diagnose and determine a range of possible
solutions for various medical problems. Laypersons simply
do not have comparable levels of specialized training or
knowledge.
However, there is another understanding of epistemic
hierarchy at stake hereone that can lead to a third type
of epistemic injustice. In medical science, there are explicit
or implicit rankings of various investigative methodologies, which directly or indirectly confer more credibility
upon those who practice the privileged approach(es). This
intermethod notion of epistemic hierarchy is prevalent
in the research arena, determining what constitutes
evidence and what kind of evidence is acceptable. In
medical research, quantitative methods that emphasize
objectivity and detachment, such as double-blind randomized clinical trials, are presumably designed to avoid
projective errors and are traditionally considered to be
categorically superior to all other forms of inquiries in
medical research regardless of the subject matter or the
type of research question. While attention to scientific or
epistemic rigor is important in medicine and other
research areas, many feminist philosophers of science
and epistemologists have cautioned against uncritical or
premature dismissal or demotion of certain methodologies
without consideration of the inquiry context. Theorists
including Sandra Harding (1998), Helen Longino (2001),
and Nancy Potter (2001) caution that the insistence on
scientists being value-free is self-deceptive and unrealistic,
since value judgments can help guide many processes and
products of knowledge creation. Some, such as Elizabeth
Anderson (2011), also challenge the presumption of
objectivity in quantitative methods by exposing the
androcentric and sexist biases in scientific research,
especially in theories about women, about sexuality, and
BIOETHICS, 4TH EDITION

Epistemic Injustice

about racial and gender differences. Moreover, methods

most suitable for investigating particular phenomena
depend on the questions asked and the kinds of
knowledge sought after. Anderson and others warn of
the unfair dismissal of various kinds of sound research that
are associated with feminine cognitive styles or
methodologies such as qualitative research, especially
when there may be situations where these methodologies
may yield knowledge that is inaccessible or less accessible
by masculine or quantitative means. For example, as
Janice Morse demonstrates in a 2006 paper, The Politics
of Evidence, while qualitative research may not be
suitable for evaluating the efficacy of drugs or other
treatments, it can be most appropriate in examining the
art of care as well as the science of care, including issues
primarily concerned with relationships, interactions, and
the context of care.
Categorical exclusion or degradation of certain
methodologies as capable of producing knowledge and
of those who employ such methodologies can lead to a
myopic understanding of the issues being studied and
further disadvantage these people in the construction of
knowledge, rendering it a form of epistemic injustice.
Even as medical professionals generally attend to patients
under highly specific circumstances (e.g., in clinics and
hospitals) for very short periods and may not have
opportunities to directly observe their daily activities,
clinicians objective assessments are often considered
categorically superior to and more trustworthy than
patients own narrative accounts. In the area of mental
health, the advent of behaviorism and more recent
advances in neuroimaging technologies have rendered
self-reports irrelevant if the latter are not corroborated by
more objective verification. Uncritical acceptance of an
entrenched epistemic hierarchy that precludes or at least
discourages challenges from those with different perspectives and different methodologies can have significant
impact on clinicians ability to provide appropriate care.
OVERCOMING AND PREVENTING EPISTEMIC
INJUSTICE

Given that epistemic injustice can harm its victims, many

feminist epistemologists advocate being mindful of biases
and prejudice. Systemically, there are also questions of
how to build trust across communities, particularly with
marginalized populations, that may be necessary to foster
epistemically strong practices. After all, people who
distrust the medical communities may not find their
claims credible, which can interfere in the achievement of
many practical goals inherent in medical inquiry, such as
seeking appropriate treatments for various conditions and
particular patients. In minimizing distrust and epistemic
injustice, Fricker (2007), Anita Ho (2011), and others
argue for inculcating a disposition to neutralize the impact
BIOETHICS, 4TH EDITION

of prejudice on our credibility judgments, or developing

epistemic humility that recognizes the collaborative
process of knowledge creation and refrains from prematurely dismissing others and their perspectives in such
endeavors. Theorists including Linda Alcoff (2010),
Lorraine Code (2008), and Kristina Rolin (2009) go
further and argue for according epistemic privilege to the
marginalized and empowering them to speak out or
advocate on their own behalf.
In the health care setting, a commitment to epistemic
humility requires professionals to restrict their claims to
knowledgerecognizing only what they actually know
about their specialized domainand to acknowledge their
fallibility. Such commitment appreciates that clinical care
is an interdependent and collaborative activity. It
recognizes that both the health care provider and the
patient are counting on each other in investigating a full
picture of the patients experiences and in determining the
most appropriate management strategies. A commitment
to epistemic justice also attempts to guard against
dogmatic approaches to health care and to confirm
medical professionals goodwill. In the age of patientcentered care, actively collaborating with patients in such
decisions has epistemic and ethical advantages. It allows a
fuller consideration of the intertwining perspectives and
factors that impact patients situations, thereby refining or
enhancing professionals own understanding of their
theoretical framework and promoting responsive patient
care.
Disability: III. Models of; Global Health
Inequalities and Inequities; Information Disclosure,
Ethical Issues of; Informed Consent; Justice; Naturalism; Prisoners as Research Subjects; Professional-Patient
Relationship: II. Ethical Issues; Research Ethics Consultation; Research Methodology; Science, Philosophy of;
Social Justice; Students as Research Subjects; Trust

SEE ALSO

BIBLIOGRAPHY

Alcoff, Linda. 2010. On Judging Epistemic Credibility: Is Social

Identity Relevant? In Engendering Rationalities, edited by
Nancy Tuana and Sandra Morgan, 5380. Albany: State
University of New York Press.
Anderson, Elizabeth. 2011. Feminist Epistemology and Philosophy of Science. Stanford Encyclopedia of Philosophy. Accessed
March 24, 2013. http://plato.stanford.edu/entries/feminism
-epistemology/
Coady, David. 2010. Two Concepts of Epistemic Injustice.
Episteme 7 (2): 10113.
Code, Lorraine. 2008. Advocacy, Negotiation, and the Politics of
Unknowing. Southern Journal of Philosophy 46 (1): 3251.
Fricker, Miranda. 2003. Epistemic Injustice and a Role for
Virtue in the Politics of Knowing. Metaphilosophy 34 (12):
15473.

1041

Ethics
Fricker, Miranda. 2007. Epistemic Injustice: Power and the Ethics of
Knowing. Oxford: Oxford University Press.
Goldman, Alvin. 2001. Experts: Which Ones Should You
Trust? Philosophy and Phenomenological Research 63 (1):
85110.
Grasswick, Heidi. 2010. Scientific and Lay Communities:
Earning Epistemic Trust through Knowledge Sharing.
Synthese 177 (3): 387409.

Inquiry, edited by Sandra Harding and Jean OBarr, 26582.

Chicago: University of Chicago Press.
Silvers, Anita. 1998. Formal Justice. In Disability, Difference,
Discrimination: Perspectives on Justice in Bioethics and Public
Policy, edited by Anita Silvers, David Wasserman, and Mary
Mahowald, 13145. Lanham, MD: Rowman & Littlefield.
Anita Ho

Harding, Sandra. 1998. Is Science Multicultural? Postcolonialisms,

Feminisms, and Epistemologies. Bloomington: Indiana University Press.

Associate Professor, Centre for Applied Ethics,

University of British Columbia
Director, Ethics Services, Providence Health Care,
Vancouver, British Columbia

Hardwig, John. 1985. Epistemic Dependence. Journal of

Philosophy 82 (7): 33549.
Hartsock, Nancy. 1987. The Feminist Standpoint: Developing
the Ground for a Specifically Feminist Historical Materialism.
In Feminism and Methodology: Social Science Issues, edited by
Sandra Harding, 15780. Bloomington: Indiana University
Press.
Haslanger, Sally. 1999. What Knowledge Is and What It Ought
to Be: Feminist Values and Normative Epistemology.
Philosophical Perspectives 33 (13): 45980.

ETHICS
This entry consists of the following:
I. HISTORY OF ETHICS

Michael A. Slote
II. TASK OF ETHICS

Assya Pascalev

Ho, Anita. 2008. The Individualist Model of Autonomy and the

Challenge of Disability. Journal of Bioethics Inquiry 5 (23):
193207.

III. METAETHICS

Ho, Anita. 2011.Trusting Experts and Epistemic Humility in

Disability. International Journal of Feminist Approaches to
Bioethics 4 (2): 10223.

V. RELIGION AND MORALITY

Hookway, Christopher. 2010. Some Varieties of Epistemic

Injustice: Reflections on Fricker. Episteme 7 (2): 15162.
Lakeman, Richard. 2010. Epistemic Injustice and the Mental
Health Service User. International Journal of Mental Health
Nursing 19 (3): 15153.
Longino, Helen. 2001. The Fate of Knowledge. Princeton, NJ:
Princeton University Press.
Maitra, Ishani. 2011. The Nature of Epistemic Injustice.
Philosophical Books 51 (4): 195211.
McLeod, Carolyn. 2002. Self-Trust and Reproductive Autonomy.
Cambridge, MA: MIT Press.
Michel, Vicki. 1995. Suicide by Persons with Disabilities
Disguised as the Refusal of Life-Sustaining Treatment. HEC
Forum 7 (23): 12231.
Morse, Janice. 2006. The Politics of Evidence. Qualitative
Health Research 16 (3): 395404.
Pfeiffer, David. 1999. The Categorization and Control of People
with Disabilities. Disability and Rehabilitation 21 (3): 1067.
Potter, Nancy. 2001. How Can I Be Trusted? A Virtue Theory of
Trustworthiness. Lanham, MD: Rowman & Littlefield.
Radden, Jennifer. 2012. Recognition Rights, Mental Health
Consumers, and Reconstructive Cultural Semantics. Philosophy, Ethics, and Humanities in Medicine 7:6.
Rogers, Wendy. 2002. Is There a Moral Duty for Doctors to
Trust Patients? Journal of Medical Ethics 28 (2): 7780.
Rolin, Kristina. 2009. Standpoint Theory as a Methodology for
the Study of Power Relations. Hypatia 24 (4): 21826.
Rose, Hilary. 1987. Hand, Brain, and Heart: A Feminist
Epistemology for the Natural Sciences. In Sex and Scientific

1042

James Nelson
IV. NORMATIVE ETHICAL THEORIES

W. David Solomon
Robin W. Lovin

I. HISTORY OF ETHICS
Ethics as a philosophical or theoretical discipline is
concerned with tasks that concern ordinary, reflective
individuals. Since its origins in classical and preclassical
times, it has sought to understand how human beings
should act and what kind of life is best for people. When
Socrates and Plato dealt with such questions, they
presupposed or at the very least hoped that they could
be answered in timeless fashion, that is, with answers
that were not dependent on the culture and circumstances
of the answerer, but represented universally valid, rational
conclusions.
In fact, however, the history of philosophical or
theoretical ethics is intimately related to the ethical views
and practices prevalent in various societies over the
millennia. Although philosophers have usually sought to
answer ethical questions without regard to (and sometimes in defiance of) some of the standards and traditions
prevalent around them, the history of ethics as a
philosophical discipline bears interesting connections to
what has happened in given philosophers societies and
the world at large. Perhaps the clearest example of this lies
in the influence of Christianity on the history of
theoretical ethics.
Philosophical/theoretical ethics, of course, has had its
own influence on Christianity, for example, Aristotles
influence on the philosophy of Thomas Aquinas and on
BIOETHICS, 4TH EDITION