Research

I study and write about the relationships between “silence” and oppression in health and healthcare, while also researching accessibility, education, and the relationships between all of these. My research areas include: Applied ethics (especially bioethics), feminist philosophy, philosophy of disability and disability studies, philosophy of medicine, and social epistemology. I have other teaching and research competence in Chinese philosophy, ethics (broadly construed), epistemology, health studies, and philosophy of science.

Below, I describe my two current research projects: (1) my dissertation project on silence and oppression in health and healthcare; and (2) a side-interest project on suicide, disability, and death. Note: The summaries below are written to be more accessible to a broader audience, because my research impacts and is impacted by a broad audience. Are you looking for a more concise or academic summary of my research that uses academic phrases like “epistemic oppression” or “necropolitics”? Please email me for other resources.

My main research: Silence in health and healthcare

In everyday language, I study and research issues where topics of knowledge and health overlap. My main interests around knowledge and health are about which kinds of knowledge are valued or “listened to,” and what the consequences are when certain kinds of knowledge aren’t valued, aren’t listened to, or are otherwise “silenced.” I believe this is especially important in healthcare, because sometimes the consequences mean that some people don’t get the care they need, or even die preventable deaths. My hope is that studying the different kinds of silences that exist can help us to access and provide better health care, and to build toward more desirable futures.

Maybe you or someone you know has visited a hospital and felt frustrated because you weren’t being taken seriously, that you were sent home without getting the care you need because of a misunderstanding. I that vague sentence doesn’t resonate with you, you may have seen many stories of these sorts in the news: people who die in waiting rooms because their concerns aren’t taken seriously, or those who are refused the tests they want because it is assumed that they are overstating their pain or experiences. (And maybe those “misunderstandings” are because of something more like outright prejudice or discrimination based on your appearance or identity). That’s an everyday example of the kinds of things I research: what would have helped avoid those ways of silencing, or to help us be heard in the right kinds of ways?

But there are many other reasons we might not be “heard” in the right ways. For example, sometimes people can’t even get into a hospital in the first place due to public policies, economic disparities, citizen status, distance to health institutions, or other access barriers. Those people aren’t listened to either. Maybe we don’t receive pain management for certain procedures because “the science” doesn’t say it makes a difference, even if it might make a difference for us, and even if the science itself is based on research that silenced certain people. Or, we could think about medical research and teaching, not just the delivery of health care, and might wonder why certain groups of people aren’t represented in how we research or teach or talk about medicine and health. How is it, for example, that our skin care specialists have gone on for so long being trained to recognize skin conditions on white people, but not conditions on the skin tones of people of colour?

Often when we look closer at these kinds of questions, we find that they are very closely connected to histories of oppression, and that these issues impact certain social groups more than others. I focus most on people who are disabled, queer, or transgender, since these are groups and communities I belong to. But there is a lot of overlap between these groups, and between each of these groups and other groups of people as well. These are all some of the things that I am researching for my dissertation

That’s what I research, and it is also important to consider where I research. I conduct my research through the Department of Philosophy and the Joint Centre for Bioethics at the University of Toronto, where I am a PhD Candidate and Vanier Scholar. The University of Toronto is located on land that belongs to and is protected by many Indigenous peoples, including the Huron-Wendat, the Seneca, and the Mississaugas of the Credit River. The land is subject to many important treaties and promises, including the One Dish One Spoon or Dish With One Spoon wampum belt.

I think it is important to name these peoples, promises, and places when we talk about research, not only to get settler colonials like me to reflect on the ongoing history and legacy of colonialism and the privileges we’re afforded, but also to try to resist the “silences” around Indigenous presences and issues in healthcare. Often, conversations with and about Indigenous peoples are absent from research. Other times, our research profits from the using ideas and histories of Indigenous peoples without credit. And all too regularly we ignore the ways that violence to the land and the environment have influenced all of these. For example, a lot of my research of silence talks about what some people call “narrative ethics” and “narrative medicine.” That is, theories that talk about the general importance of stories for health. But with only very few exceptions, most of these hundreds of articles and conversations don’t mention or try to learn from the rich narrative practices of the Indigenous peoples local to where they research and learn. This kind of silence, I think, not only harms our own research by missing out on really well established ways of thinking about stories and communication, and thus trying to ‘reinvent the wheel,’ but also harms our research by excluding Indigenous peoples from the “our” in “our research” and by discrediting many different Indigenous knowledges that are already undervalued by Western approaches to knowledge and research.


A side project: Suicide beyond fatalities

I’m someone who has a lot of different relationships to what we call suicide: I have witnessed people die by suicide, I have had people close to me die by suicide, I have attempted myself to die by suicide. Notice that in those examples, I talk about those who die by suicide: the emphasis is on death. I believe that thinking more fully about suicide requires thinking more than just the moment or outcome of death. I don’t think this is a relatively surprising claim: we regularly talk about varieties of self harm, about suicidality or suicidal ideation, and other related figures. (Well, I say “regularly talk about,” but we actually don’t tend to talk about suicide very much at all). Still, when it comes to a lot of public talk and research on suicide, we usually measure the impacts of suicide largely just in terms of death. I’m interested in building a broader picture of suicide, and in thinking about the relationships between suicide, death, and disability. It might seem odd to wonder about the relationship between suicide and death, since suicide is usually just understood as a particular kind of death. But I think that the closer we look, the more we can find interesting middle spaces between the two.

Here’s one example I’ve been using to talk about suicide and death lately: the COVID-19 pandemic. While the science is not yet settled, and while there are going to be many differences for different groups of people around the world, one outcome people have found interesting is that the rate of deaths by suicide in Canada have seemed to drop during the COVID-19 pandemic. Why is this surprising? Well, many of the models we have for understanding suicide tell us that people who are experience social isolation and loneliness, and those who have less access to healthcare support, seem to be at greater risk of engaging in suicide behaviours. So, many people expected to see an increase in suicide rates because the pandemic increased our isolation (those of us who follow basic public health guidance anyway), and have made it harder for many people to access forms of healthcare. (I know that my own therapy sessions felt very different online or by phone than they did from in person). But it seems like the opposite has happened: the rates of deaths by suicide seem to have gone down!

I don’t want to suggest that this isn’t possibly good (though I also don’t think that all suicides need preventing… but that’s a different topic). What I want to do with my research is complicate this picture a little bit. Here is one story I think we could find plausible: the number of people who died by suicide went down because people who tried to die by suicide didn’t have the same access to more lethal means of dying by suicide. With the pandemic, there have been many public health measures that make it harder for people to access certain means to lethal outcomes. That is, maybe those people who did try to die by suicide only had access to less-lethal ways of engaging in suicide behaviours, and so, even if they did try to die by suicide, did not end up dying at the same rate our data is used to. And, maybe these people ended up with complicated health issues as a result, or maybe they ended up ‘fine.’

Note that I am not saying that this is what happened (we don’t have the evidence to say either way), just that it might seem like a plausible story. And if it is plausible, then we might think that while death rates have decreased, that the broader picture of suicide hasn’t necessarily improved. So, this is one example of why focusing on death numbers doesn’t necessarily give us the best picture of the state of suicide in the world.

This is what my ‘pet’ project is exploring: the relationships between death and suicide. But my fuller goal for this project is also to look closely at the role of disability in all of this. I worry that if we say something like “our suicide situation may be just as bad, or worse, because people are becoming disabled instead of dying,” that this plays into a really harmful way of thinking about and talking about disability: that disability is a necessarily undesirable way of being in the world. But, while I think we really shouldn’t be saying that disability is necessarily undesirable, that we also want to give some importance to the different kinds of health outcomes that people may experience (and in particular, that they may experience as undesirable). So, my research plan is to explore this fuller messy area of suicide: the relationships between suicide and disability, disability and death, suicide and death, and all the other messy spaces that overlap between them.

I will be sharing some of my earlier thoughts about this project in two different online events. The first is February 16th, in a “Seminar Series” run by the Joint Centre for Bioethics, where I’ll be giving a talk titled “Reconsidering Suicide: A Morbid Approach” (where “morbid” is a bit of a play on words, referring to “morbidity” in a medical sense). Later, in April, I’ll be giving a talk at the University of Pennsylvania’s Minorities and Philosophy conference on disability and illness; that one is titled “Disabling Suicides and COVID-19.” They both have different titles because I plan to have different focuses between them, though they both address the general themes I’ve described here.