Abstract:
This paper develops the concepts of bounded knowledge and epistemic selectivity to examine how chronic illness-disability is constrained within medical and disability frameworks, each of which offers only a partial perspective. 
Drawing on Mol’s account of ontological multiplicity and Dewey’s theory of selectivity, I argue that what comes to count as authoritative knowledge is structured through epistemic boundaries that privilege certain interpretations while excluding others.

Using qualitative research with 563 people living with Intracranial Hypertension (IH) as a case study, I show how bounded language operates as a key mechanism for maintaining bounded knowledge. Participants described the inadequacy of terms such as ‘headache’ or ‘migraine’ to convey IH pain, reaching instead for embodied expressions such as ‘my head being crushed in a vice’. Clinical vocabulary, while authoritative, could not carry the weight of their experience. When knowledge becomes embedded within medical frameworks, alternative meanings struggle to be recognised as credible. Many participants also found it difficult to locate themselves within dominant models of disability. Their fluctuating and often invisible experiences sat uneasily within both medicalised narratives and disability categories.

I conceptualise this as a borderland space produced by epistemic selectivity. This selectivity generates refused knowledge in multiple directions, echoing Fricker’s account of epistemic injustice. Each perspective is situated and partial, yet unequally empowered. Engaging cripistemology and disability justice, I argue that moving beyond partial perspectives requires rethinking how knowledge about chronic illness-disability is produced and validated. Recognising the bounded nature of all frameworks opens space for more relational and politically attentive ways of knowing across chronic illness contexts.