Reframing Patient and Parental Experience in Pediatric Healthcare: Medical Gaslighting as a Diagnostic Safety Vulnerability

Medical gaslighting has emerged as a widely used term describing situations in which patients or caregivers perceive that their symptoms are minimized, dismissed, or prematurely attributed to psychological causes without adequate clinical evaluation. Although the term has gained prominence through patient narratives and public discourse, many of the underlying mechanisms correspond to well-established contributors to diagnostic error, including cognitive bias, communication failures, and diagnostic overshadowing. In pediatric care, these challenges are amplified because clinicians frequently rely upon caregiver-mediated histories while children may have a limited ability to communicate evolving symptoms. This narrative review examines medical gaslighting through the framework of diagnostic safety and explores how epistemic injustice, cognitive bias, and failures in information gathering and interpretation may contribute to delayed, missed, or incorrect diagnoses. Relevant literature was identified through a structured narrative review of publications addressing diagnostic error, cognitive bias, epistemic injustice, diagnostic safety, and pediatric communication. The literature was synthesized conceptually to develop an integrated framework linking patient experiences with established diagnostic safety models. We propose that reframing medical gaslighting as a diagnostic safety vulnerability rather than an allegation of clinician misconduct provides opportunities for measurable quality improvement through enhanced communication, structured reassessment, cognitive debiasing strategies, and integration of patient- and caregiver-reported information into diagnostic reasoning.