Original articlesEpistemic Injustice A Philosophical Analysis of Women's Reproductive Health Care in a Somali-American CommunityNarruhn, Robin PhD, MN, RN; Clark, Terri PhD, CNM, ARNP, RN, FACNMAuthor Information College of Nursing, Seattle University Washington. Correspondence: Robin Narruhn, PhD, MN, RN, College of Nursing, Seattle University, 901 12th Ave, PO Box 222000, Seattle, WA 98122 ([email protected]). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Advances in Nursing Science: January/March 2020 - Volume 43 - Issue 1 - p 86-100 doi: 10.1097/ANS.0000000000000283 Buy Metrics Abstract Epistemology is the study of the grounds of knowledge. We illustrate through case studies how epistemic injustice is manifested in the delivery of reproductive health care services for women from Somalia, even though it may not be intended or recognized as injustice. Testimonial injustice occurs when women are not believed or are discredited in their aim to receive care. Hermeneutic injustice occurs when a significant area of one's social experience is obscured from understanding owing to flaws in group knowledge resources for understanding. For example, women from Somalia may not receive full disclosure about the diagnostic or treatment services that are recommended in the reproductive health care setting. We explore how the many intersections in a person's identity can give rise to epistemic injustice and we suggest more expansive ways of evaluating the validity of diverse epistemologies in patient-centered care. Structural competency is recommended as a way nurses and other health care providers can mitigate the social determinants of health, which contribute to epistemic injustice. © 2019 Wolters Kluwer Health, Inc. All rights reserved.