New Findings in Social Science and Medicine Described from Maastricht University (Questions regarding ‘epistemic injustice’ in knowledge-intensive policymaking: Two examples from Dutch health insurance policy)

2019 DEC 23 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Health and Medicine - Social Science and Medicine. According to news reporting out of Maastricht, Netherlands, by NewsRx editors, research stated, “In contemporary healthcare policies the logic of Evidence-based Medicine (EBM) is typically proposed as a way of addressing a demand to explicitly justify policy decisions. Policymakers’ use of ‘evidence’ is presumed to pertain to ideals of justice in decision-making.”

Financial support for this research came from National Health Care Institute for facilitating and financing.

Our news journalists obtained a quote from the research from Maastricht University, “However, according to some, EBM is liable to generate ‘epistemic injustice’ because it prefers quantitative types of evidence and -as a result of that -potentially undervalues the qualitative testimonies of doctors and patients. Miranda Fricker’s concept of ‘epistemic injustice’ refers to a wrong done to a person in their capacity as a knower. This paper explores the usefulness and limits of this concept in the context of public decision-making. How is evidence-based policymaking intertwined with questions of ‘epistemic injustice’? Drawing from ethnographic research conducted at the National Health Care Institute, we analyze two cases of EBM-inspired policy practices in Dutch social health insurance: 1) the use of the principles of EBM in making a public reimbursement decision, and 2) private insurers’ use of quantitative performance indicators for the practice of selective contracting on the Dutch healthcare market. While the concept of ‘epistemic injustice’ misses some key processes involved in understanding how ‘knowing gets done’ in public policy, it does shed new light on priority-setting processes. Patients or medical professionals who are not duly recognized as credible and intelligible epistemic agents, subsequently, lack the social power to influence priority-setting practices. They are thus not merely frustrated in their capacity to be heard and make themselves understood, they are potentially deprived of a fair share in collective financial and medical resources.”

According to the news editors, the research concluded: “If we fail to recognize inequalities in credibility and intelligibility between diverse groups of knowers, there is a chance that these epistemic inequalities are being reproduced in our system of health insurance and our ways of distributing healthcare provisions.”

For more information on this research see: Questions regarding ‘epistemic injustice’ in knowledge-intensive policymaking: Two examples from Dutch health insurance policy. Social Science & Medicine, 2019;245():112674. Social Science & Medicine can be contacted at: Pergamon-Elsevier Science LTD, the Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, England. (Elsevier - www.elsevier.com; Social Science & Medicine - http://www.journals.elsevier.com/social-science-and-medicine/)

Our news journalists report that additional information may be obtained by contacting F. Moes, Research School CAPHRI, Dept. of Health, Ethics and Society, Maastricht University, PO Box 616, 6200 MD, Maastricht, Netherlands. Additional authors for this research include E. Houwaart, D. Delnoij and K. Horstman.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.socscimed.2019.112674. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal Social Science & Medicine is: Pergamon-Elsevier Science LTD, the Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, England.

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