<?xml version="1.0" encoding="UTF-8"?><?xml-stylesheet type="text/xsl" href="static/style.xsl"?><OAI-PMH xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/ http://www.openarchives.org/OAI/2.0/OAI-PMH.xsd"><responseDate>2026-04-13T15:15:33Z</responseDate><request verb="GetRecord" identifier="oai:www.recercat.cat:20.500.14342/3991" metadataPrefix="marc">https://recercat.cat/oai/request</request><GetRecord><record><header><identifier>oai:recercat.cat:20.500.14342/3991</identifier><datestamp>2025-05-15T19:19:41Z</datestamp><setSpec>com_2072_482405</setSpec><setSpec>com_2072_183628</setSpec><setSpec>col_2072_482409</setSpec></header><metadata><record xmlns="http://www.loc.gov/MARC21/slim" xmlns:dcterms="http://purl.org/dc/terms/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:doc="http://www.lyncode.com/xoai" xsi:schemaLocation="http://www.loc.gov/MARC21/slim http://www.loc.gov/standards/marcxml/schema/MARC21slim.xsd">
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      <subfield code="a">dc</subfield>
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      <subfield code="a">Rosàs Tosas, Mar</subfield>
      <subfield code="e">author</subfield>
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   <datafield ind2=" " ind1=" " tag="260">
      <subfield code="c">2021-10</subfield>
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      <subfield code="a">Background: The evaluation of pain remains one of the most difficult challenges that healthcare practitioners face.&#xd;
Chronic pain appears to affect more than 35% of the population in the West, and indeed, pain is the most common&#xd;
reason patients seek medical care. Despite its ubiquity, studies in the last decades reveal that many patients feel their&#xd;
pain is dismissed by healthcare practitioners and that, as a result, they are denied proper medical care. Buchman, Ho,&#xd;
and Goldberg (J Bioethic Inq 14:31-42, 2017) point to this phenomenon as a form of “epistemic injustice”: an unfair&#xd;
and harmful downgrading of credibility affecting some individuals and groups, which prevents them from receiving&#xd;
appropriate and beneficial medical care.&#xd;
Methods: By exploring the existing literature on this downgrading of patients’ credibility written by healthcare&#xd;
professionals and scholars in medical humanities, I identify and examine the reasons patients are often not believed&#xd;
about their pain and why healthcare is too-often unhelpful or hurtful to people presenting with chronic pain. I also&#xd;
explore to what extent it is possible to forge an alternative epistemological model.&#xd;
Results: I suggest that most of the causes of this downgrading of patient’s credibility result from either the difficulty&#xd;
in communicating pain or the widespread belief that pathology is always the result of objective tissue damage. I&#xd;
examine whether pain has to be effectively communicated and have an objective cause in order for it to be deemed&#xd;
credible. In the end, I argue that in the case of pain, both communication and objectivity are highly problematic.&#xd;
Conclusions: I conclude by suggesting that, although alternative epistemological models might be impossible to&#xd;
build, believing patients has both moral and clinical benefits, and this warrants further research.</subfield>
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      <subfield code="a">http://hdl.handle.net/20.500.14342/3991</subfield>
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   <datafield ind1="8" ind2=" " tag="024">
      <subfield code="a">https://doi.org/10.1186/s13010-021-00105-x</subfield>
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   <datafield tag="653" ind2=" " ind1=" ">
      <subfield code="a">Veritat i mentida</subfield>
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      <subfield code="a">Comunicació</subfield>
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   <datafield tag="653" ind2=" " ind1=" ">
      <subfield code="a">Injustícia epistèmica</subfield>
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      <subfield code="a">Objectivitat</subfield>
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   <datafield tag="653" ind2=" " ind1=" ">
      <subfield code="a">Dolor</subfield>
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      <subfield code="a">Escepticisme</subfield>
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      <subfield code="a">Subjectivitat</subfield>
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   <datafield ind2="0" ind1="0" tag="245">
      <subfield code="a">The Downgrading of pain sufferers’ credibility</subfield>
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