Medical gaslighting: conceptual and theoretical foundations, 2026, Noble

[Hutan]

You can't truly help an Ill person until you understand what they need from their perspective, and in their terms,

I don't think that is true. If you have a good understanding of disease and treatments, a lot of the time you will be able to provide very useful help without knowing for sure exactly what the patient 'needs from their perspective and in their terms'. The proof of that is that doctors in an Emergency Room can often provide substantial help to an unconscious patient who is unable to inform their medical team of their perspective.

Frankly, give me any day competent ethical 'biological reductionism' and 'chauvinism derived from [an accurate understanding of the] relationship between pathogenic causes to symptoms' over an incompetent doctor who wants to spend time trying to understand what I need from my perspective and in my terms.

My perspective about what I need could easily be wrong - lots of people's perspectives have been that they need homeopathy or to suspend themselves by a rope around their neck in order to cure CCI or drink bleach or jump on a paper circle and shout 'Stop!'.

Sure, patients with capacity should always be able to refuse medical care and to make informed choices, for example, in end of life care. But it seems to me that the further away medicine gets from biology and good quality evidence, the higher the chance of medical gaslighting, patient exploitation, deceit and charlatanism.

 

[Jonathan Edwards]

Frankly, give me any day competent ethical 'biological reductionism' and 'chauvinism derived from [an accurate understanding of the] relationship between pathogenic causes to symptoms' over an incompetent doctor who wants to spend time trying to understand what I need from my perspective and in my terms.

Absolutely.
And it has nothing to do with 'materialism' which is a bogey invented by philosophers to justify their preference for talking about everything from a position of ignorant intuition. I am not a materialist.

 

[JellyBabyKid]

By definition, denying a patients lived experience and reality must cause some kind of harm

Epistemic injustice = denying someone is a reliable narrator of their own experience

Traumatic invalidation = repeated invalidation of someone's experience or reality

Potentially leading to moral injury = profound psychological distress from actions (or inactions) that violate one's deeply held moral or ethical beliefs, leading to intense guilt, shame, anger, and loss of trust, often stemming from betrayals by authority

I have been giving this area of psychology a lot of thought, when able.

 

[JellyBabyKid]

Does anyone know how to access the full article free? Ty.

No, but I would also be interested to read it if anyone gets hold of a copy. Thanks

 

[hallmarkOvME]

Absolutely.
And it has nothing to do with 'materialism' which is a bogey invented by philosophers to justify their preference for talking about everything from a position of ignorant intuition. I am not a materialist.

Thank you for disclosing that.

 

[hallmarkOvME]

My perspective about what I need could easily be wrong - lots of people's perspectives have been that they need homeopathy or to suspend themselves by a rope around their neck in order to cure CCI or drink bleach or jump on a paper circle and shout 'Stop!' It seems to me that the further away medicine gets from biology and good quality evidence, the higher the chance of medical gaslighting, patient exploitation, deceit and charlatanism.

We all have the self determined right to be wrong, and it ethically (deontically) precedes anyone else's notion of the good. The only time limiting that right is justified is when it interferes with, or clearly amd presently portends to interfere with, another's same right.

But it seems to me that the further away medicine gets from biology and good quality evidence, the higher the chance of medical gaslighting, patient exploitation, deceit and charlatanism.

Biology and good evidence are necessary but insufficient conditions to protect and enforce that right; they can neither guarantee nor enforce it. And it isn't medicine that moves away or makes ethical choices; it's other agents with their own self determination. Are you saying that the presence of or intervention of the doctor protects patients from medical gaslighting, patient exploitation, deceit and charlatanism from others? And if so, isn't that itself paternalistic?

 

[Utsikt]

We all have the self determined right to be wrong, and it ethically (deontically) precedes anyone else's notion of the good. The only time limiting that right is justified is when it interferes with, or clearly amd presently portends to interfere with, another's same right.

Biology and good evidence are necessary but insufficient conditions to protect and enforce that right; they can neither guarantee nor enforce it. And it isn't medicine that moves away or makes ethical choices; it's other agents with their own self determination. Are you saying that the presence of or intervention of the doctor protects patients from medical gaslighting, patient exploitation, deceit and charlatanism from others? And if so, isn't that itself paternalistic?

The patient’s right to refuse any medical treatment without it negatively impacting the other medical care they receive, effectively protects their agency. That mechanism sometimes doesn’t work, but that’s a different question entirely.

It is the doctor’s duty to make the best recommendations they can based on their knowledge and experience. That is the social contract we’ve entered into with them - they have to act in our best interest from a medical perspective. That will to some extent include disagreeing with the patient about what they think they need.

If you want to drink bleach you are usually allowed to drink bleach. But a doctor should not recommend or approve of you doing it just because that is what you want.