A new article in Synthese argues that psychiatry’s reliance on standardized diagnostic tools, such as the DSM and questionnaires like the PHQ-9, may contribute to structural forms of epistemic injustice.
Philosopher Virginia Ballesteros contends that psychiatry’s pursuit of objectivity often comes at the expense of patient perspectives, flattening complex personal experiences into predetermined symptom categories.
“For the sake of objectivity, patients have to be treated at best as mere informants, or at worst as sources of information—either way, they are not treated as epistemic agents,” Ballesteros writes.
“The conception of objectivity as standardization is, I argue, a contributing structural factor to several forms of epistemic injustice.”
Since there are no biological markers or lab tests for most psychiatric conditions, psychiatry has turned to standardization—checklists, psychiatric interviews, and Likert scales—to bring order to what would otherwise be subjective and variable presentations. However, Ballesteros argues that these tools simplify complexity and impose a framework that often excludes what patients themselves consider most significant. They transform narratives into data points and patients into information providers, undermining the possibility of authentic epistemic engagement.
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