Inaudible and invisible: epistemic injustice and the failure of recognition as a single intersubjective relation. Pain as particularly illuminating case.
TL;DR
It is argued that, in the clinical encounter with a person in pain, the relation between the two is not exhausted by causal succession, and these are analytically separable dimensions of a single intersubjective relation.
Abstract
Miranda Fricker's concept of epistemic injustice and Axel Honneth's theory of recognition have each been applied, separately, to chronic pain. The relationship between them is usually construed as sequential: epistemic injustice is thought to produce failures of recognition, or prior misrecognition to ground later epistemic marginalisation. This article rejects that reading. It argues that, in the clinical encounter with a person in pain, the relation between the two is not exhausted by causal succession. They are analytically separable dimensions of a single intersubjective relation, dimensions that cannot, in that encounter, be treated apart without descriptive and practical loss. The act by which a clinician withholds credibility from a patient's testimony is the same act by which recognition is refused to that patient as a suffering subject. The claim is offered as a heuristic rather than an ontological thesis. Pain is presented not as uniquely paradigmatic but as a particularly illuminating case within a broader class of testimonially dependent suffering, since its privacy, its dependence on testimony, and the mediating role of diagnostic language converge in it with unusual clarity. The argument bears on recognition theory; on medical ethics, where remedies addressed to one dimension alone prove insufficient; and on clinical practice, where diagnostic classification operates as a technology of recognition.