Medical Gaslighting, Trustworthiness, and the Limitations of Mutual Distrust

Medical gaslighting occurs when clinicians undermine patients’ first-person authority to make claims about their own experiences, leading patients to doubt their own perceptions, beliefs, motivations, and even their sanity. This concept has proven useful for individuals to understand, convey, and find support in the aftermath of a specific type of harmful experience. However, there is much more that remains to be done in terms of clarifying and changing structural conditions that enable medical gaslighting. Elizabeth Barnes identifies many factors that compromise the quality of health care patients with marginalized identities receive without providing a method for describing how biases at the level of medical institutions and professionals enable medical gaslighting. Barnes is concerned that calls to “trust patients” as a remedy for medical gaslighting will lead physicians to grant patients too much credibility. She develops an alternative that addresses the question—under what conditions should physicians trust patients? I am concerned with a different question—under what conditions should patients trust physicians? Critical phenomenology provides a method both for describing individuals’ lived experiences of medical gaslighting and avoidable misdiagnoses. It also elucidates how structural conditions make both possible and more likely for patents who are members of marginalized groups, especially when there is medical uncertainty. These are not simply failures of competence among individual physicians; they stem from systemic biases in medical education and norms of clinical practice.