Chronic Pain, Etiology, and 'Medical Gaslighting'

(in progress)

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Abstract Barnes (2023) argues that, whereas patients have legitimate authority regarding their subjective experiences (e.g., pain), they generally do not have legitimate authority about objective causal facts (e.g., pathology), since authority about such matters requires clinical expertise. Therefore, in Barnes’ view, the dismissal of patient perspectives regarding the causes of their symptoms usually doesn’t constitute medical gaslighting. While I agree with Barnes that many patients might misinterpret the precise causes of their symptoms, I believe they nonetheless possess relevant information that is often too easily discounted in clinical contexts, with medical practitioners unjustifiably imposing their own interpretation onto the patient. For example, when a medical professional attributes the patient’s physical symptoms to stress, depression, or anxiety, the patient may have important information challenging the plausibility of that explanation. This might include knowledge of the symptom onset, relevant life circumstances, or the absence of prior psychological stressors or psychiatric conditions. I argue that when such testimony is dismissed, it can—and often does—constitute a form of medical gaslighting.