The Erasure of the Face: A Levinasian Critique of Dismissive Medicine and Medical Gaslighting and Their Implications for Philosophical Health
Gabay GillieABSTRACT
Rationale
Dismissive medicine (DM), minimization, psychologization, or ignoring physical symptoms in clinical encounters, constitutes a profound rupture of the clinical alliance. Medical gaslighting (MG), a special case of DM, refers to the internalization of DM following encounters, creating self‐doubts and eroding the patient's epistemic self‐trust.
Aims and Objectives
Moving beyond individualized critiques, the study analyzes DM and MG through an expanded framework of Levinasian ethics.
Methods
Each participant ( n = 17) completed two interviews, the first upon hospital‐discharge, following acute, life‐threatening crises, and the second ~1 month later.
Findings
The DM phenomenon freezes the patient's vulnerable narrative expression (The Saying) into dogmatic categorizations of patients (The Said). Participants' accounts illustrate how clinicians, facing the competing claims of other patients and the institutional obligations of justice that Levinas associates with the Third, may resolve these pressures through protocols that remain open to revision or epistemic shortcuts that totalize and thematize vulnerable subjects, reducing the complex unmapped bodily suffering into psychological classifications like somatic anxiety.
Conclusions
Mitigating DM and MG requires a reorientation away from a rigid application of evidence‐based care toward care that preserves room for narrative competence, epistemic humility, and the patients' foundational philosophical health.