%0 Journal Article
%T Recognizing the Patient Whose Account Is Doubted: An Epistemic Justice Framework for Interpreting Chronic Pain, Contested Symptoms, and Diagnostic Uncertainty in Clinical Care
%A Sofia Lindqvist
%A Maria Papadopoulou
%A Ahmed El-Sayed
%A Laura Mendez
%J Asian Journal of Ethics in Health and Medicine
%@ 3108-5059
%D 2026
%V 6
%N 2
%R 10.51847/hPndOvIwSk
%P 35-44
%X Clinical care frequently requires decisions before symptoms are fully explained, diagnoses are secure, or competing interpretations have been resolved. In such settings, patients whose accounts concern chronic pain, medically unexplained symptoms, or other contested conditions may encounter a distinctive ethical problem: legitimate clinical uncertainty can coexist with credibility practices that progressively diminish the epistemic standing of the person reporting the symptoms. This article develops a conceptual framework for distinguishing uncertainty-sensitive clinical interpretation from epistemically unjust credibility discounting. Drawing on contemporary work on testimonial and hermeneutical injustice, institutional epistemic arrangements, chronic-pain experience, diagnostic uncertainty, clinical documentation, and bias in pain assessment, the analysis argues that epistemic justice cannot require clinicians to treat every patient claim as factually correct. Its more defensible demand is that patient testimony remain consequential, revisable, and capable of altering inquiry while evidence is assessed. Four features are central: defeasible credibility, inquiry proportional to unresolved uncertainty, interpretive openness to experiential knowledge, and preservation of the patient's capacity to influence subsequent assessment. Credibility injustice arises when uncertainty is converted into a comparatively stable presumption against the patient, especially where that presumption narrows inquiry, shapes documentation, or makes later testimony easier to disregard. The framework therefore treats epistemic justice as compatible with disciplined doubt while identifying conditions under which doubt becomes structurally self-reinforcing. It offers a basis for more precise clinical interpretation without replacing evidentiary judgment with automatic belief.
%U https://smerpub.com/article/recognizing-the-patient-whose-account-is-doubted-an-epistemic-justice-framework-for-interpreting-ch-kvkphjnaqf3ylvo