Vulnerability in People with Mental Disorders: Biological Disadvantage or Epistemic Injustice?

People with mental illness have traditionally been considered vulnerable populations. They are frequently subjected to discrimination, stigma, marginalization from social projects, mistreatment and physical, psychological and sexual abuse. The dominant biological medical model of medicine states that this vulnerability is biological, excluding social elements from both medical practice and training. In this article, we propose vulnerability as the effect of epistemic injustice, rather than biological disadvantage. To this end, we will first critique the characterization of mental illnesses only as biological diseases, on the one hand, and the application of under-inclusive and over-medicalized care measures, on the other. Secondly, we will take the concept of “epistemic injustice” as central to the generation of such vulnerability in these populations. This concept proposes a situation in which a subject is structurally excluded from the generation and interpretation of knowledge by his or her society, as is the case of people with mental illnesses, condemned precisely to be excluded from the generation and interpretation of valuable knowledge for the development of a social project in which they can participate. Finally, we will explore some possible solutions to such epistemic injustices, as well as their effects on the vulnerability of those who suffer from such conditions.

vulnerability, mental disorders, epistemic injustice, hermeneutical injustice

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