Courtroom Epistemics: Framing OST Patients in Juridification and Drug Policy Debates

• In Event: Crime, Science and Politics WG Panel 2 : Innovation and Access in Justice Systems

Abstract

This paper examines a civil court case in which a general practitioner lost his license for allegedly irresponsible treatment of patients regarding opioid substitution treatment (OST) — a decision that has resonated as a symbol of contemporary challenges in drug policy in Norway. Drawing on observations from the appellate trial, analysis of court documents, and in-depth interviews with OST patients and health professionals, the study examines the dynamics of courtroom discourse in the context of public health.

The case reveals how legal proceedings, while ostensibly designed to protect patients, often marginalize their voices. Expert testimony — predominantly from medical professionals — is privileged, casting patient testimonies as unreliable and reducing them to a secondary role in defining sound treatment. This dynamic not only silences the lived experiences of those directly affected but also reinforces existing power structures within legal debates.

The study further engages with the problems of juridification, where complex social and health issues are translated into narrow legal arguments. By reducing multifaceted challenges to matters of proof and rule adherence, the judicial process risks oversimplifying the profound ethical and practical dilemmas inherent in drug policy. The reliance on expert testimony contributes to a double marginalization: patients are both controlled by the state and disempowered in their own narratives of harm.

In dialogue with Nils Christie’s theory of conflicts as property and Miranda Fricker’s concept of epistemic injustice, this paper calls for a critical re-examination of how legal arenas construct expertise and legitimacy — ultimately questioning whether the current judicial framework adequately addresses the intricacies of public health and drug policy.

Author

• Tara Matilde Søderholm, VID Specialized University