Ignore the words/ignore the hurts. Discourse and practices of epistemic silencing in medical consultations in the municipal health network in Franca (Brazil).

In Brazil, research on access to care in the public health system reveals a number of inequalities in care faced by certain patients - particularly women, the working classes and racialized minorities, during medical consultations. The aim here is to highlight a specific form of prejudicial treatment known as epistemic injustice. Based on observations and consultation’s reporting in health posts, emergency departments and hospitalization services in Franca (Brazil), we will see how these injustices are often co-produced by the existence of negative social prejudices against patients, a lack of awareness of social inequalities in health, a more or less authoritarian exercise of power by the doctor and a rigid application of certain medical procedures. Three forms of 'epistemic silencing' (Dotson, 2011) have been identified: 'not believing', 'not saying' and 'silencing'. [ABSTRACT FROM AUTHOR]