Epistemic Injustice in Nursing Knowledge Production: A Three-Pillar Framework for Recognition, Redistribution, and Representation.

Western-centric knowledge paradigms in nursing perpetuate epistemic injustice by systematically excluding racialized, Indigenous, and Global South ways of knowing from legitimate nursing discourse. Despite growing critical scholarship on this problem, no widely cited framework has yet translated foundational theories of epistemic injustice and social justice into a discipline-specific, operational governance tool for nursing institutions. This discursive paper examines how Western-centric knowledge paradigms in nursing contribute to epistemic injustice and develops an operational framework for epistemic justice in nursing education, research, and practice. A critical interpretive synthesis of literature from nursing philosophy, decolonial studies, critical pedagogy, and global health ethics was conducted using theoretical sampling across CINAHL, PubMed, Scopus, and Web of Science (1990-2025). The single-author interpretive synthesis was appropriate for theory generation, with saturation understood as the point at which additional texts did not introduce new framework-relevant constructs, rather than implying comprehensive coverage of the field. The paper develops three concrete outputs: a three-pillar framework for epistemic justice comprising Recognition, Redistribution, and Representation; measurable operational indicators for each pillar including citation equity indices, syllabus diversity audits, and leadership representation metrics; and a six-question decision audit tool designed to support institutional self-assessment of epistemic justice. The framework is explicitly positioned as an initial synthesis intended to support future collaborative development with Global South, Indigenous, and racialized nursing scholars. Achieving epistemic justice demands structural change to what counts as legitimate nursing knowledge. The paper further argues that decolonizing nursing knowledge requires not merely diversifying existing frameworks but interrogating the colonial foundations upon which dominant nursing epistemologies have historically rested. No patient or public involvement occurred in the design or writing of this discursive article.