Evidence map›Paper›PMID 42881683›Full record

ReviewHealthcare (Basel, Switzerland)2026

Medical Gaslighting in Urban Healthcare: A Bioecological Framework for Health Equity and Participatory System Transformation.

Anthony D Slonim, Mustafa Naveed, Kryss Shane

Abstract readReview
In one paragraph

Review in Healthcare (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Anthony D SlonimDepartments of Internal Medicine, Pediatrics, Health Systems and Interprofessional Sciences, Virginia Tech Carilion School of Medicine, Roanoke, VA 24014, USA.
Mustafa NaveedDepartment of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA 24014, USA.
Kryss ShaneDepartment of Social Work, National University, San Diego, CA 92123, USA.ORCID 0000-0002-3923-0888

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Medical gaslighting describes patient experiences in which symptoms, concerns, or interpretations of illness are minimized, dismissed, or insufficiently recognized within healthcare encounters. While the term initially emerged from patient and community narratives, recent empirical and conceptual studies (2019-2024) have further documented patterns of diagnostic overshadowing, credibility deficits, and structural contributors to patient invalidation. These findings indicate that interpersonal dismissal often reflects broader organizational and systemic dynamics. This paper proposes a bioecological framework for understanding medical gaslighting as a multi-level phenomenon within urban healthcare. Drawing on Bronfenbrenner's bio-ecological theory, Fricker's concept of epistemic injustice, Lipsky's theory of street-level bureaucracy, and participatory traditions advanced by Dewey, Freire, and community-based participatory research, the framework examines how experiences of invalidation arise through interactions among patients, clinicians, healthcare organizations, policies, and communities. Participatory approaches position patients and communities as partners in defining problems, generating knowledge, and designing solutions. This framework conceptually advances participatory knowledge production as a mechanism for organizational learning and system transformation. Addressing medical gaslighting requires more than improving communication; it requires recognizing lived experience as legitimate knowledge and redesigning healthcare systems to support partnership, continuity, and learning from the patients and communities they serve. Because this model has not yet been empirically validated, its components should be interpreted as theoretical propositions intended to guide future research. By connecting individual experiences to system-level transformation, healthcare organizations can strengthen equity, trust and human-centered care.

Indexed as

bioecological theorycare fragmentationdiagnostic overshadowingepistemic injusticehealthcare systemshealth equitymedical gaslightingparticipatory researchpatient-centered caretrusturban health

Identifiers

PMID42881683
PMCPMC13664893

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.