Epistemic Injustice and Children’s Well-Being

Author(s):  
Christina Schües
Author(s):  
Jessica Begon

Is disability disadvantageous? Although many assume it is paradigmatically so, many disabled individuals disagree. Whom should we trust? On the one hand, pervasive mistrust of already underrepresented groups constitutes a serious epistemic injustice. Yet, on the other, individuals routinely adapt to mistreatment and deprivation and claim to be satisfied. If we take such “adaptive preferences” (APs) at face value, then injustice and oppression may not be recognized or rectified. Thus, we must achieve a balance between taking individuals’ preferences and self-assessment as definitive, and ignoring them entirely. Furthermore, current accounts of APs suffer from an ambiguity: are APs an unreliable guide to individuals’ interests, or to just policy? This chapter argues that we should distinguish between those that are unreliable in the former sense (“well-being APs”), and the latter (“justice APs”). Although all APs are nonautonomous, only well-being APs are irrational. Thus, preferences may be diagnosed as unreliable from the perspective of justice without impugning individuals’ rational capacities.


Affilia ◽  
2019 ◽  
Vol 34 (2) ◽  
pp. 151-169 ◽  
Author(s):  
Catrina Brown

Women are at least twice as likely to experience depression as men, and up to 25% of women can expect to be depressed in their lifetimes. Depression is likely to recur in up to 85% of women, yet most women who experience depression cope on their own. Feminist research has explored the discursive, and social context of depression among women and acknowledges women’s agency as they simultaneously struggle and cope with depression. “Getting on with life” is often an imperative, but begs the question what are they getting on with, especially if their lives have been significant in causing unhappiness and distress. I explore how depression is shaped by the discourse of self-management, gender performance and the notion “the good woman.” Dominant depression discourses individualize, decontextualize, and emphasize personal responsibilization for the causes and treatment of depression. This produces an epistemic injustice for speaking about and coping with depression. Social work practitioners must make space for acknowledging women’s resourcefulness and agency in their management of sadness and distress. We must also address not only the dangers of responsibilization, but the limitations of this approach to women’s well-being.


2020 ◽  
Vol 24 (4) ◽  
pp. 241-255
Author(s):  
Olivia Sagan

Purpose This study aims to explore the lived experience of loneliness among a group of people diagnosed with the contested diagnosis of borderline personality disorder (BPD). In so doing, it contributes to works offering dimensional conceptualisations of personality disorders and contributes to loneliness study more broadly which has seen a rise in interest since the Covid-19 epidemic and the subsequent enforced isolation and the resultant new phenomenon of sudden loneliness. Design/methodology/approach Participants with diagnoses of BPD were recruited through a combination of calls through online fora and announcements at self-help groups. A total of 25 people made contact, with interviews eventually being carried out with 14 of these. They were invited to take part in unstructured, recorded one-to-one interviews. Thematic analysis was used in this study, which used a narrative phenomenological approach using an Arendtian lens. Findings Through attending to the interwoven themes in the narratives of trauma, loss and loneliness, it emerged that the enduring loneliness experienced was compounded by repeated instances of testimonial injustice. Research limitations/implications This study supports the need for a further deepening of our understanding of the complexity of experience at the interface of loneliness and mental ill health. Practical implications This study critiques the reductive assumptions behind websites, simplistic tool kits and training within the mental health arena dictating “what works” for loneliness. The paper argues for health professionals to develop a more nuanced listening to reported loneliness and that part of what may compound this complex experience among people diagnosed with personality disorder is epistemic injustice, rife within a climate of neoliberalism. Social implications Neoliberalism has been identified as a key driver of distinct shifts in mental health policy and the commodification of mental health. Its fixation with medicalisation and its drive to treat “mental illness” as a problem within the individual positions people as self-contained agents and downplays, or worse, ignores the social, cultural and economic dimensions that contribute to the person’s distress. Neoliberalism’s discourse of “responsibilization” for example, urges individuals that families, communities and workplaces rather than publicly funded services become the main resources to respond to in times of mental distress. This, however, assumes a concreteness to these institutions which may be illusory and leaves those in difficulty dependent on presumed immediate social circles. These circles, however, if they exist, may contain the very people who have failed individuals or subjected them to the testimonial injustices so often cited in the narratives of this research. Originality/value The Arendtian account of loneliness rests on the premise that the human being of contemporary society is afflicted with a sense of isolation and homelessness, further exacerbated in today’s neoliberal context. By drawing on this account, the enmeshed and complex nature of mental illness, loneliness and dislocation from society and the ways in which continued epistemic injustice negatively impact on mental well-being are laid bare. Phenomenology of loneliness goes some way to helping people without the devastating life experiences common to those diagnosed, rightly or not, with a personality disorder gain a sense of the experience, and this research argues for psychological practice to be more mindful of this literature and the value of closely heard first-person narratives.


2019 ◽  
Vol 28 (2) ◽  
pp. 274-284 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Louise Hickson ◽  
Carly Meyer

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.


2017 ◽  
Vol 2 (10) ◽  
pp. 109-115 ◽  
Author(s):  
Jennifer Oates ◽  
Georgia Dacakis

Because of the increasing number of transgender people requesting speech-language pathology services, because having gender-incongruent voice and communication has major negative impacts on an individual's social participation and well-being, and because voice and communication training is supported by an improving evidence-base, it is becoming more common for universities to include transgender-specific theoretical and clinical components in their speech-language pathology programs. This paper describes the theoretical and clinical education provided to speech-language pathology students at La Trobe University in Australia, with a particular focus on the voice and communication training program offered by the La Trobe Communication Clinic. Further research is required to determine the outcomes of the clinic's training program in terms of student confidence and competence as well as the effectiveness of training for transgender clients.


2010 ◽  
Vol 19 (3) ◽  
pp. 68-74 ◽  
Author(s):  
Catherine S. Shaker

Current research on feeding outcomes after discharge from the neonatal intensive care unit (NICU) suggests a need to critically look at the early underpinnings of persistent feeding problems in extremely preterm infants. Concepts of dynamic systems theory and sensitive care-giving are used to describe the specialized needs of this fragile population related to the emergence of safe and successful feeding and swallowing. Focusing on the infant as a co-regulatory partner and embracing a framework of an infant-driven, versus volume-driven, feeding approach are highlighted as best supporting the preterm infant's developmental strivings and long-term well-being.


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