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Major study will use philosophical expertise to highlight patient voices in healthcare research and practice

Monday, 13 March 2023

A new six-year study, which aims to prevent the ‘silencing’ of patient voices and improve patient trust in the healthcare system, is due to begin thanks to a major funding award

Researchers at the University of Nottingham, University of Bristol and University of Birmingham have received a £2.6M Wellcome Discovery Grant for the 'Epistemic Injustice in Healthcare (EPIC)’ project. The study will use philosophical expertise to explore forms of 'silencing'.

Patients regularly report that their testimonies and perspectives are ignored, dismissed or explained away by the healthcare profession. These experiences are injustices because they are unfair and harmful - and philosophers call them ‘epistemic injustices’ because they jeopardise patient care and undermine trust in healthcare staff and systems.

By studying these epistemic injustices, EPIC will find ways to correct them and improve the relationship between patients and healthcare practitioners.

The EPIC team has internationally-recognised expertise in philosophy, psychiatry, and law. Principal Investigator, Professor Havi Carel from the University of Bristol, is an authority on philosophy and phenomenology of illness.


EPIC will provide the first systematic study of epistemic injustice across a range of healthcare settings. It will be the first to offer a set of empirical studies that will show how and when epistemic injustice appears. EPIC will also be the first funded project to seek ways to overcome epistemic injustice. We are incredibly excited and grateful to Wellcome to be given this opportunity to improve crucial aspects of healthcare, like communication, which is at the core of every healthcare interaction.
Professor Havi Carel, Principal Investigator, University of Bristol

Professor Carel will be joined by fellow Bristol academic, Professor Sheelagh McGuinness, who is an authority on health, gender, and the law. Dr Ian James Kidd, Assistant Professor in Philosophy, will lead the research at the University of Nottingham. Dr Kidd, an epistemologist and philosopher of illness, pioneered the study of epistemic injustices in healthcare with Professor Carel.

Patients have long reported feeling ignored, dismissed, or silenced in ways that jeopardise their care and intensify their suffering. The challenge is to understand how this silencing happens and what can be done about it, in ways that can help patients and healthcare practitioners alike. The NHS is right to seek 'patient perspectives' and listen to 'patient voices'. Project EPIC will help them to do that better by fully diagnosing the causes of that silencing.
Dr Ian James Kidd, EPIC Co-Investigator & Assistant Professor in the Department of Philosophy

The University of Birmingham team is Professor Lisa Bortolotti, a philosopher of psychiatry and editor of the ‘Philosophical Psychology’ journal, and Professor Matthew Broome, an academic NHS psychiatrist and Director of the Birmingham Institute for Mental Health. Commenting on the study, Professor Bortolotti said: "It is especially important for people with a mental health diagnosis to contribute to shared knowledge concerning their symptoms and treatment. This study will challenge the assumption that they are irrational or disconnected from reality, and so not worthy of being listened to."

The EPIC team will be completed by eight postdoctoral researchers and a range of other researchers and collaborators from Swansea, City and Aston Universities, as well as the Universities of Bologna and Ferrara in Italy, making a team of around 30 researchers.

The six case studies include labour pain, child mental health, neurodiversity, cancer and depression, and later-life care.

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