2026/01/31 by José Eduardo Porcher, Felipe José Santaella · 1 voice
Social Sciences · #Race, Identity, and Education in Brazil #Religion and Society in Latin America #Cultural Competency in Health Care
paper · doi:10.1080/09515089.2026.2623889
openalex publication_date 2026/01/31 · openalex created_date 2026/02/03 · openalex updated_date 2026/07/22
This paper develops a normative account of epistemic injustice in psychiatric contexts by analyzing a clinical encounter involving M. a twelve-year-old girl whose meaning-making draws upon an Afro-Brazilian religious framework that was excluded in a hospital setting. We argue that this exclusion exemplifies interpretive exclusivism—a mechanism through which clinicians override patients’ primary meaning-making resources in domains where medicine lacks interpretive authority. Building on established work on testimonial smothering and contributory injustice, we show how M. and her mother, J. were denied uptake for their Afro-Brazilian religious interpretation, undermining their ability to understand M.’s experiences, corroding J.’s self-trust as an interpreter of her daughter’s condition, and foreclosing potential sources of care. We further situate this dynamic within a history in which African-derived religions in Brazil have been pathologized, criminalized, and culturally devalued, thereby revealing a racialized pattern of epistemic harm that exceeds generic tensions between religion and biomedicine. Finally, we examine M. and J.’s acts of epistemic resistance and consider the implications of our analysis for clinical practice. Promoting epistemic justice in psychiatry, we argue, requires epistemic humility: recognizing the limits of medical authority and engaging meaningfully with the diverse interpretive frameworks patients rely on to understand their lives.