Journal of evaluation in clinical practice
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When one is seriously ill, the diagnosis given can generate questions about what it means and how to make sense of it. This is particularly the case for psychiatric diagnoses which can convey a biomedical narrative of the sufferer's condition. Making sense of one's diagnosis in such cases can involve changing one's self-narrative in such a way as to incorporate the belief that one has developed a disease with an unknown cause. ⋯ I argue that those receiving a psychiatric diagnosis may consequently be vulnerable to epistemic injustice. In particular, this includes hermeneutical injustice, where individuals lack the ability to understand or articulate their experiences in ways that make sense to them, due to their hermeneutical resources being marginalised by the dominant narrative in a medicalized environment. I consider two possible objections to my claim and offer answers to these.
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Evidence-based practice is the principle governing a range of healthcare practices and beyond. However, it has suffered from a lack of philosophical rigour. This paper sets out to analyse the epistemological basis of evidence-based practice. ⋯ There is a need to re-think the epistemological basis for evidence-based practice. Evidence-based practice is out of touch with developments within philosophy of science.