From silencing to desinformation

Epistemic Injustice and the Crisis of Trust in Health

Abstract

This theoretical-analytical essay investigates the contemporary crisis of health disinformation as a symptom of a deeper, structural failure: epistemic injustice. The article argues that the proliferation of disinformation and the chaos of the infodemic are not merely technological problems but direct consequences of a knowledge ecosystem where trust has been systematically eroded. The analysis articulates the framework of epistemic injustice—notably the concepts of testimonial and hermeneutical injustice—with the phenomena of informational disorder, demonstrating how the discrediting and silencing of certain subjects, especially patients, create a vacuum of authority that false and pseudoscientific narratives exploit. The post-truth culture is thus reinterpreted as a consequence of the failure of hegemonic institutions to act in an epistemically just manner. As an alternative to reactive fact-checking strategies, a model of "epistemically just health" is proposed. This theoretical construct focuses on restoring trust through the practice of epistemic virtues in clinical settings, institutional accountability against willful ignorance, and the promotion of critical health literacy as a tool for patient emancipation.