"It's Shaking Your Entire Construction as a Human Being": A Qualitative Analysis on Epistemic Injustice and Medical Gaslighting Consequences in Patients Living with Chronic Pain.

Abstract

Patients living with chronic pain often report experiencing invalidation from healthcare practitioners. Epistemic injustices, that is, the disqualification of a person as a knower, have been used to study medical encounters and chronic pain invalidation. However, these studies are largely theoretical and tend to reproduce epistemic injustices by not giving a voice to the people directly impacted by these injustices. This research is focused on enhancing our understanding of the consequences of epistemic injustice in health care. We conducted seventeen qualitative narrative interviews with people living with chronic pain in the province of Québec, Canada. The results support many consequences that were already identified in the theoretical literature, including the impact on patients' interaction with the healthcare system, but also less-discussed consequences, including the impact of epistemic injustices on patients' agency. We discuss emancipation and resistance strategies to epistemic injustices, as well as the implications of the results for health equity.