"Play!": Combatting Pathocentric Epistemic Injustice in Chronic Pain Care.

Abstract

Epistemic injustice is an analytical framework that is used to describe a wrong done to someone in their capacity as a knower. Epistemic injustice is well-documented across the healthcare spectrum, particularly in relation to the patient's capacity to understand, and thus derive meaning from, the experience of illness. This article contributes to the body of scholarship exploring how to achieve pathocentric epistemic justice by way of ethnographic case study. Findings draw on fieldwork conducted at a small, publicly funded chronic pain clinic. At MB clinic, pain care is delivered in a group setting. Patients and doctor exhibit a playful attitude: they lean into uncertainty, tell jokes, and eschew the concept of mastery. This produces an epistemic environment that departs from the kind critiqued in studies wherein epistemic injustice is present. By way of case study, this article provides support for the broad claim that there is a link between playfulness and epistemic well-being. Therefore, playfulness may be applied as a strategy to combat pathocentric epistemic injustice.