Abstract

We argue that people who are incarcerated and prison health workers are impacted by embodied institutional epistemic injustice. This particular epistemic state results in prison health workers practicing “health harm” instead of health care in prison medical wards. The paper begins by providing background data on incarceration, aging, and health. It then engages the concept of institutional epistemic injustice by framing it as an epistemic component of nonideal theory through the work of Charles Mills and Elizabeth Anderson, and then extending their arguments to understand institutional epistemic injustice as an activity of institutional structures that is imposed on people and embodied. This embodied understanding of institutional epistemic injustice is applied to understanding the health and health care of people who are aging in the U.S. carceral system. It does so by analyzing the effects of this embodied epistemic state on people who are incarcerated and the people who are responsible for caring for their health. We argue that prison health workers take on the harm mentality of the carceral system engaging their patients as prisoners and not as patients. They thus engage in health harm and not health care in their relationship with people who are in their medical care. We end with some key epistemic strategies derived from epistemic injustice and applied to the health and health care of people who are ill, aging, and dying in prison.