When Care Does Not Count: Epistemic Injustice and the Organisational Recognition of Nursing Knowledge

ABSTRACT

This discussion paper examines how care‐based nursing judgement becomes recognised, narrowed or excluded as professional knowledge within healthcare organisations. Nursing care is often described as relational, ethical, practical or compassionate, yet these descriptions may obscure its epistemic content: trained perception, contextual interpretation, anticipatory reasoning, moral judgement, continuity work and practical synthesis under uncertainty. Drawing on epistemic injustice, nursing knowledge development, care ethics and organisational governance, the paper argues that injustice in nursing knowledge is not only interpersonal but organisational. It identifies three mechanisms through which care‐based nursing knowledge may be downgraded: credibility distortion, interpretive narrowing and restricted epistemic uptake. The paper further develops the idea of reductive recognition: care may become visible in organisational systems only after being translated into categories that diminish its nursing rationality. Five organisational conditions are proposed for recognising care as knowledge: credible reception, hermeneutic infrastructure, shared knowledge governance, educational preparation and balanced standardisation. The central contribution is to shift the question from whether nurses possess knowledge to how healthcare organisations decide which forms of nursing knowledge are allowed to count.

1. Introduction: When Care Does Not Count

Healthcare organisations do not only deliver care; they also shape the conditions under which knowledge becomes credible, intelligible and actionable. This is visible in ordinary organisational situations: when a nurse escalates concern about deterioration, when handover information is treated as routine communication rather than clinical reasoning, when electronic documentation captures task completion but not contextual rationale, or when nurses are present in governance forums without decision rights over evidence standards. In each case, the issue is not whether nursing work occurs, but whether nursing judgement is institutionally recognised as knowledge.

Contemporary systems often attach legitimacy to knowledge that can be standardised, coded, audited, compared and circulated through formal infrastructures. This orientation is necessary for safety, accountability, documentation and research. This paper does not reject standardisation, auditability or documentation. Rather, it examines the epistemic costs that arise when these become the dominant conditions under which nursing knowledge is allowed to count. The problem is not the existence of metrics, protocols or standardised languages; the problem is their dominance when they displace the interpretive, relational, contextual and anticipatory dimensions of nursing judgement.

Nursing work is a continuous source of clinical interpretation. Nurses observe deterioration, coordinate care, interpret patient responses, anticipate risk, sustain continuity and mediate between patients, families, professionals, protocols and organisational demands. These activities are not merely practical tasks. They involve disciplined judgement under conditions of uncertainty. Carper (1978) articulated empirical, ethical, personal and aesthetic patterns of knowing in nursing; later nursing knowledge development scholarship expanded attention to practical, emancipatory, theoretical and reflective dimensions of disciplinary knowledge (Benner 1984; Chinn and Kramer 2018). Yet organisations may recognise nursing contribution most readily when it is translated into documentation fields, measurable indicators, standardised terminologies or operational tasks.

This contradiction can be examined through epistemic injustice: a wrong done to people or groups in their capacity as knowers (Fricker 2007). In healthcare, epistemic injustice has often been used to analyse how patients' testimony may be discounted or rendered unintelligible within clinical systems (Carel and Kidd 2014). This patient‐centred concern remains essential. The present paper adds a complementary organisational and disciplinary level of analysis: how nursing, as a knowledge‐bearing profession, may be constrained by institutional arrangements that shape credibility, interpretive resources and participation in knowledge governance.

Recent scholarship supports the plausibility of this broader framing, although it does not by itself demonstrate the framework proposed here. Epistemic injustice in multiprofessional healthcare teams may arise when medical dominance deflates the credibility of non‐medical perspectives (Bueter and Jukola 2025). In nursing education, epistemic injustice has been identified as relevant to professional formation and mental health nursing practice (Fisher 2024). Ethnographic work on redesigning nursing work also shows that nursing knowledge is shaped by struggles over what counts as legitimate evidence, innovation and improvement (Kuijper et al. 2024). These studies suggest that epistemic injustice is not only interpersonal; it may be embedded in roles, documentation systems, professional hierarchies and governance routines.

This paper uses leadership, structure and culture (LSC) as sensitising organisational concepts, drawing on prior theoretical work that conceptualises LSC as an organisational framework for examining how nursing knowledge is legitimised, structured and culturally sustained (Antuna‐Casal 2026). LSC is not presented here as a closed causal model, a leadership taxonomy or a generic management checklist. Rather, it identifies three interdependent organisational locations through which healthcare institutions confer legitimacy on knowledge, stabilise decision pathways and normalise professional meanings. Leadership matters because it can confer or withhold epistemic legitimacy; structure matters because roles, routines, documentation systems, escalation pathways and governance mechanisms determine whether judgement can leave an institutional trace, and culture matters because shared meanings shape whether care is interpreted as knowledge, task completion, attitude, compassion or moral background. The central argument is that nursing does not lack epistemic capacity. Rather, healthcare organisations may fail to provide the conditions under which care‐based nursing judgement can consistently become credible, intelligible and consequential. The paper therefore examines how care comes not to count, and what forms of organisational recognition would be required for care‐based nursing knowledge to be treated as knowledge.

2. The Paradox of Epistemic Recognition

The argument advanced in this paper is not simply that nursing care should be made more visible. Visibility is necessary, but it is not sufficient. Care‐based nursing judgement may become visible in organisational systems while losing much of its epistemic content. It may appear as a completed task, a coded intervention, a compliance marker, a communication entry, a risk score or an indicator of activity, while the reasoning that made the judgement clinically and morally significant disappears. In such cases, care is not wholly excluded; it is recognised in a reduced form.

This creates a paradox of epistemic recognition. Healthcare organisations may seek to value nursing by documenting it, measuring it, standardising it and incorporating it into governance systems. These processes can strengthen safety, accountability, continuity and research. However, they can also narrow the terms on which nursing knowledge becomes institutionally intelligible. The danger is not only that care remains invisible, but that it becomes visible only when translated into categories that make it epistemically smaller. A concern about deterioration may become a tick‐box escalation. A relational judgement may become a note about communication. A contextual interpretation may become a compliance problem. A moral concern may become a documentation gap. The organisation sees something, but not necessarily the knowledge that nursing has produced.

The central problem, therefore, is not whether care can be represented within organisational systems, but whether those systems preserve the rationality of care‐based judgement. Recognition is epistemically just only when nursing judgement can enter organisational deliberation as reason‐bearing knowledge: open to examination, contestation, documentation and action, but not forced to abandon its own forms of reasoning in order to be taken seriously. This distinction matters because epistemic injustice can occur not only through silence or exclusion, but also through reductive inclusion. Nursing knowledge may be admitted into the organisation while being stripped of the interpretive, anticipatory, relational and ethical reasoning that made it nursing knowledge in the first place.

This paper therefore does not argue for uncritical acceptance of nursing judgement. Nor does it oppose documentation, standardisation, audit or evidence‐based governance. Rather, it asks a more specific question: under what organisational conditions can care‐based nursing judgement become visible without being epistemically diminished? This question reframes recognition as more than professional validation. It becomes a matter of how organisations distribute authority over meaning, evidence, documentation and action.

3. Relationship to Missed Care, Fundamentals of Care and Invisible Nursing Work

The framework proposed here should be read as an extension of, rather than a substitute for, existing nursing scholarship on missed care, fundamentals of care and the invisibility of nursing work. Literature on missed nursing care, care left undone and rationed nursing care has been crucial in showing how organisational conditions, staffing pressures, prioritisation and systems constraints shape what care is delayed, omitted or incompletely delivered (Ball et al. 2014; Chaboyer et al. 2021; Kalisch 2006; Schubert et al. 2008). Scholarship on the fundamentals of care has been equally important in challenging the assumption that basic care is simple, low‐status or merely task‐based (Feo et al. 2018; Kitson 2018). Work on invisible nursing labour has shown that much of what nurses contribute to safety, continuity, interpretation, coordination and patient experience can remain poorly recognised in formal organisational systems (Allen 2014).

The present paper contributes to these conversations by specifying the epistemic dimension of the problem. Its concern is not only whether care is performed, omitted, visible or valued, but whether the judgement embedded in care is received as knowledge. This distinction allows for a more precise organisational diagnosis. Missed care draws attention to what is not done, delayed or incompletely completed. Invisibility draws attention to what is done but not seen. Fundamentals of care scholarship draws attention to the complexity of care that may be wrongly treated as basic, simple or merely compassionate. Epistemic injustice adds a further question: when nurses generate knowledge through care, do organisational systems provide conditions for that knowledge to become credible, intelligible and capable of shaping action?

This question is particularly important at the level of leadership and systems. Asking nurses to speak up, document more fully or demonstrate confidence is insufficient if the organisational conditions of reception remain unchanged. Nursing judgement may be voiced without being believed, recorded without being interpreted, represented without decision rights or translated into indicators that no longer preserve its reasoning. The proposed framework therefore aligns with systems‐level nursing scholarship while adding a specific conceptual language for analysing how organisations distribute epistemic authority over care‐based judgement.

4. Conceptual Orientation

This is a theory‐based conceptual analysis. It does not report empirical findings, present a systematic review or make claims about the prevalence of epistemic injustice across healthcare settings. Conceptual inquiry is appropriate when a field requires clarification of constructs, boundaries, assumptions and implications for research and practice (Pesut and Johnson 2008; Sharifi‐Heris and Bender 2023). The aim is analytic and normative: to identify plausible institutional mechanisms through which nursing knowledge may be downgraded and to specify conditions under which care‐based knowledge can be more reliably recognised and used.

The conceptual corpus was selected purposively to include four bodies of scholarship necessary to the argument: epistemic injustice and social epistemology, nursing knowledge development, care ethics and organisational governance. Texts were retained when they contributed to construct definition, mechanism specification or organisational translation. The purpose was theoretical sufficiency rather than exhaustive coverage. Other literatures, including professional jurisdiction, interprofessional power, feminist standpoint epistemology, implementation science and safety science, could extend the framework in future work.

The analysis proceeded in four steps. First, core concepts were delimited: epistemic injustice, care‐based knowledge, credibility, intelligibility, uptake and governance. Second, epistemic injustice theory was interpreted structurally rather than only interpersonally, drawing on testimonial injustice, hermeneutical injustice, epistemic oppression and epistemic resistance (Dotson 2011, 2014; Fricker 2007; Medina 2013). Third, these concepts were brought into dialogue with nursing knowledge development and care ethics, especially scholarship that treats nursing knowledge as plural, situated, interpretive, ethical and practice‐embedded (Benner 1984; Carper 1978; Chinn and Kramer 2018; Tronto 2013). Fourth, the analysis used LSC as sensitising organisational concepts to examine how institutional conditions may enable or constrain the recognition of care as nursing knowledge (Antuna‐Casal 2026).

The level of analysis is organisational and disciplinary. In this paper, the organisational level refers to institutional settings in which nursing judgement is structured, documented, authorised and incorporated into decision‐making. These include healthcare delivery organisations such as hospitals, community services, long‐term care settings and other clinical provider environments, as well as connected educational and governance settings insofar as they shape the preparation, language and institutional conditions through which care‐based reasoning becomes publicly defensible. The framework is therefore not tied to a single organisational form or national healthcare system. Rather, it is proposed as a middle‐range conceptual argument whose mechanisms require contextual specification when examined empirically. Future studies should identify the organisational setting, nursing roles, documentation systems, governance arrangements and professional hierarchies through which credibility, intelligibility and epistemic uptake are locally organised and distributed.

The paper is not primarily concerned with whether individual nurses are confident, assertive or personally respected in isolated encounters. Its concern is with institutional arrangements through which nursing judgement is received, documented, interpreted, authorised or excluded. The claims should therefore be read as conceptual propositions for future research rather than as empirical conclusions. To preserve this distinction, the paper separates descriptive claims about how organisations may distribute credibility, interpretive claims about how these arrangements can be understood through epistemic injustice theory and normative claims about what conditions would be required for nursing knowledge to be recognised as credible, intelligible and actionable.

The five conditions proposed in this paper are not presented as a measurement instrument. They are conceptual conditions intended to clarify how care‐based nursing judgement may become credible, intelligible and consequential within organisational life. Future empirical work may operationalise them differently across clinical, educational and governance settings.

5. Epistemic Injustice as an Organisational Condition in Nursing

Epistemic injustice names harm to people or groups in their capacity as knowers (Fricker 2007). In testimonial injustice, credibility is unjustly reduced. In hermeneutical injustice, shared interpretive resources are insufficient to make significant experiences, judgements or concerns intelligible. Although these concepts are often illustrated through interpersonal encounters, later scholarship shows that epistemic injustice can also be structural, sustained by institutional norms, practices and systems that distribute credibility and intelligibility unevenly (Dotson 2011, 2014; Medina 2013). For nursing, this structural reading is essential. Nurses may recognise clinically relevant changes, interpret deterioration, identify relational risk, sustain continuity or understand why a technically correct plan may fail in a specific context. Yet these forms of judgement may not receive the same status as diagnostic, technological, codified or audit‐ready forms of knowledge. The issue is not simply whether an individual nurse is believed in a particular meeting. The issue is whether healthcare organisations create durable conditions for nursing knowledge to be heard, interpreted, recorded, acted upon and incorporated into governance.

In this paper, care‐based nursing knowledge refers to disciplined professional judgement that integrates trained perception, contextual interpretation, anticipatory reasoning, relational understanding, moral responsibility and practical action. Care should therefore not be understood as a soft supplement to technical practice. Care is epistemic because it enables nurses to notice what may otherwise remain clinically invisible, including subtle deterioration, risks to continuity, family concerns, contextual barriers to adherence and situations in which protocol alone is insufficient. Recognising care as knowledge does not mean treating all nursing impressions as automatically valid. It means creating conditions in which nursing judgement can be articulated, examined, challenged, documented and used as reason‐bearing professional knowledge. Three mechanisms are especially relevant. First, credibility distortion occurs when nursing judgement is treated as informal, supportive or operational rather than as reason‐bearing clinical knowledge. Second, interpretive narrowing occurs when care is understood primarily as task completion, compassion or attitude, thereby obscuring anticipatory judgement, contextual interpretation, moral reasoning, continuity management and practical synthesis. Third, restricted epistemic uptake occurs when nursing knowledge can be expressed but does not reliably influence decisions, documentation, indicators, policies or research priorities. These mechanisms do not require intentional disrespect. This matters because organisational epistemic injustice may persist even in formally respectful teams. Systems designed for efficiency, auditability, coordination or legal accountability may nevertheless narrow the range of nursing knowledge that becomes institutionally real.

What is at stake, therefore, is not the protection of nursing judgement from critique, but its admission into the organisational space of reasons. To recognise care as knowledge is not to treat every nursing concern as correct, nor to replace empirical evidence, diagnostic reasoning or standardised documentation with professional intuition. It is to acknowledge that care‐based judgement can offer reasons: reasons for concern, escalation, adaptation, refusal, continuity, delay, advocacy or reinterpretation of a plan. Epistemic injustice occurs when those reasons cannot enter organisational deliberation on their own terms, or when they must be translated so completely into managerial, biomedical or audit‐ready categories that their nursing rationality is lost. In this sense, the problem is not simply that care is invisible. The deeper problem is that care may become visible only after being made epistemically smaller.

These mechanisms should be understood as organisationally patterned rather than merely interpersonal. LSC help explain how credibility, intelligibility and uptake are distributed within organisational life, while recognising that these dimensions are mutually reinforcing and often co‐produced. Leadership confers or withholds epistemic legitimacy. Structure materialises legitimacy through roles, routines, documentation systems, escalation pathways and governance mechanisms. Culture normalises or marginalises the meanings through which care is interpreted as knowledge. When these dimensions are aligned, care‐based nursing judgement can be received, articulated, examined and used. When they are misaligned, epistemic injustice may become institutionally reproducible. Five conditions are proposed to address these failures: credible reception, hermeneutic infrastructure, shared knowledge governance, educational preparation and balanced standardisation. Figure 1 summarises this organisational logic, while Table 1 translates it into conceptual conditions, theoretical propositions and implications for inquiry.

Figure 1.

LSC‐informed epistemic justice framework for nursing knowledge. The figure depicts care‐based nursing knowledge at the centre of two contrasting organisational pathways. The enabling pathway links leadership illegitimacy, structural uptake and cultural intelligence to epistemic justice, understood as conditions in which care‐based nursing knowledge is received, interpreted and used. The constraining pathway links leadership failure, structural exclusion and cultural narrowing to epistemic injustice, expressed through credibility distortion, restricted epistemic uptake and interpretive narrowing. The figure is a conceptual map of the framework rather than a deterministic causal model.

Table 1.

Organisational conditions for recognising care as nursing knowledge.

Organisational emphasis	Epistemic failure	Justice condition	Theoretical proposition	Implications for inquiry
Leadership	Credibility distortion	Credible reception	When leadership does not confer epistemic legitimacy on nursing judgement, nursing concerns are more likely to be treated as operational input than as clinical knowledge.	Examine whether nursing concerns influence escalation, safety review, interdisciplinary deliberation and care‐planning decisions.
Culture	Interpretive narrowing	Hermeneutic infrastructure	When organisational culture lacks concepts for care‐based reasoning, care is more likely to be reduced to task completion, attitude or compassion.	Analyse curricula, records, policies and team language for concepts that make anticipatory, relational, contextual and ethical judgement visible.
Structure	Restricted epistemic uptake	Shared knowledge governance	When structures do not give nurses decision rights in knowledge governance, nurses may contribute information without shaping evidence standards, indicators or documentation priorities.	Assess nursing participation and decision rights in clinical governance, documentation design, quality improvement and research priority setting.
Education across organisational life	Weak public articulation	Educational preparation	When education does not teach epistemic articulation, nurses may perform care competently without being prepared to justify its reasoning publicly.	Test educational interventions that strengthen articulation of care‐based knowledge, professional agency and interdisciplinary reasoning.
Structure–culture interface	Metric dominance	Balanced standardisation	When standardisation becomes the dominant route to legitimacy, nursing knowledge may become more visible while care's rationality becomes narrower.	Compare how documentation systems capture codified nursing information and contextual care‐based judgement.

Note: The organisational emphases identify primary analytic locations rather than exclusive causal sources. Credibility, intelligibility and uptake are often co‐produced across leadership, structure and culture.

6. Implications for Inquiry, Education and Governance

Building on this relationship with scholarship on missed care, fundamentals of care, invisible nursing work, leadership and systems‐level constraints, the argument developed here opens several lines of inquiry. It does not reduce epistemic justice to a measurement problem, nor does it treat organisational recognition as a matter of professional visibility alone. Rather, it asks how nursing judgement moves, or fails to move, through organisational systems of documentation, escalation, governance, evidence and accountability. This framing suggests several research directions.

First, qualitative studies could examine how nurses articulate care‐based judgement in interdisciplinary meetings, escalation processes, handovers, incident reviews or quality‐improvement forums. The key analytic question would not be whether nurses speak, but whether their concerns are treated as reason‐bearing knowledge that changes decisions, documentation, priorities or actions.

Second, organisational case studies could examine whether nursing knowledge leaves an institutional trace. Relevant data sources include safety meeting minutes, escalation records, care plans, policy documents, electronic health record templates, quality dashboards, committee terms of reference and research priority‐setting records.

Third, educational research could test interventions that strengthen nurses' capacity to articulate, justify, evaluate and defend care‐based reasoning. Outcomes could include quality of reasoning in simulation, visibility of contextual judgement in reflective writing, students' capacity to explain care‐based decisions in interprofessional settings and educators' assessment of epistemic articulation beyond technical task completion.

Fourth, intervention and implementation studies could examine documentation templates, governance procedures or leadership practices designed to improve credible reception and epistemic uptake. For example, studies could test whether structured prompts for nursing rationale in escalation documentation improve interdisciplinary response, or whether nurse participation in electronic health record design strengthens the visibility of contextual and relational judgement.

Fifth, research on standardised nursing languages should examine not only whether terminologies improve visibility, but whether they preserve or displace care‐based reasoning. Standardised nursing languages and documentation systems can improve visibility, communication, continuity, research capacity and accountability (Jones et al. 2010). Systematic reviews indicate that standardised nursing terminologies may support documentation, care planning, clinical decision‐making and outcome evaluation, although effectiveness depends on context and implementation (Rodríguez‐Suárez et al. 2023; Zhang et al. 2021). The framework therefore does not reject standardisation. Its concern is with dominance: standardisation should support professional judgement, not become the only condition under which nursing knowledge is allowed to count.

7. Recognising Care as Knowledge in Organisational Life

Recognising care as knowledge requires more than valuing nurses, encouraging voice or improving professional confidence. These responses remain important, but they are insufficient if the organisational conditions of reception remain unchanged. A nurse may speak clearly and still not be heard as a knower; a judgement may be documented and still lose its rationale; a concern may be included in a meeting and still have no effect on decisions. Epistemic recognition is therefore not equivalent to presence, participation or expression. It requires uptake. For clinical practice, this means that nursing judgement should enter deliberation as reason‐bearing knowledge. When nurses raise concerns about deterioration, continuity, risk, relational vulnerability or contextual barriers to care, the relevant organisational question is not only whether the concern was voiced, but what happened to it afterwards. Was it documented? Was it interpreted as clinical reasoning? Was it linked to action? Was disagreement possible? Did the concern alter a plan, trigger review or reshape accountability? These questions move epistemic justice from moral aspiration to organisational scrutiny.

For education, the implication is that nurses must be prepared not only to perform care, but to make the reasoning within care publicly defensible. Students and clinicians need language for explaining how observation, relational knowledge, contextual interpretation, ethical judgement, embodied familiarity and empirical evidence inform nursing decisions. Without such preparation, care may remain competent but epistemically under‐articulated, especially in interprofessional settings where dominant forms of evidence may set the terms of intelligibility. This problem can be understood as a form of hermeneutical injustice. When nurses lack shared conceptual and epistemic resources for making significant care‐based judgements intelligible to others, the issue is not merely one of confidence, communication skill or individual assertiveness. A nurse may recognise deterioration, relational vulnerability, contextual risk, family concern, ethical tension or the likely failure of a technically correct plan, yet lack an organisationally authoritative vocabulary through which these judgements can be heard as knowledge. Educational preparation must therefore support more than the performance of care. It must develop nurses' capacity to articulate the reasoning of care in ways that are publicly defensible, open to challenge and intelligible within interdisciplinary and governance settings.

For leadership and governance, the implication is sharper. Epistemic justice is not achieved by asking nurses to ‘speak up’ while leaving documentation systems, escalation pathways, committee authority, evidence standards and quality indicators unchanged. Representation without decision rights risks symbolic inclusion. Documentation without rationale risks epistemic thinning. Standardisation without interpretive space risks making nursing knowledge visible only by narrowing it. If care is to count as knowledge, organisations must examine the pathways through which nursing judgement is received, translated, challenged, preserved and allowed to matter.

8. Limitations

This paper offers a conceptual framework, not empirical evidence of prevalence or effect. The mechanisms proposed here require empirical testing across settings, specialties, countries and organisational cultures. The framework should not be used to assume that all organisations enact epistemic injustice in the same way, or that all forms of standardisation are epistemically harmful. It should also not be read as a claim that nursing judgement is immune from critique. Epistemic justice requires that care‐based reasoning can be heard, examined, challenged and used; it does not require that it be accepted uncritically. Future research should therefore test the framework's clarity, feasibility, transferability and explanatory value.

9. Conclusion

Epistemic injustice in nursing should be understood not only as a failure to listen to individual nurses, but as an organisational failure to recognise care as knowledge. Using LSC as organisational concepts, this paper has argued that the epistemic standing of nursing judgement depends on more than individual voice, confidence or professional respect. It depends on whether healthcare organisations provide conditions under which care‐based knowledge can become credible, intelligible and consequential.

The contribution of the paper is threefold. First, it extends epistemic injustice from interpersonal and patient‐centred analyses to the organisational recognition of nursing as a knowledge‐bearing discipline. Second, it identifies three mechanisms through which care‐based nursing knowledge may be downgraded: credibility distortion, interpretive narrowing and restricted epistemic uptake. Third, it proposes five conditions for recognising care as knowledge: credible reception, hermeneutic infrastructure, shared knowledge governance, educational preparation and balanced standardisation.

The central question for nursing science is therefore not only what nurses know, but how organisations decide which forms of nursing knowledge are allowed to count. This question cannot be reduced to invisibility, missed care or weak professional voice, although each remains important. Care may be performed and still not recognised as knowledge; it may be documented and still lose its rationale; it may be included in organisational systems and still fail to shape decisions. Care does not become organisationally recognisable as knowledge because it is named as care, nor because it is morally important. It becomes recognisable as knowledge when its reasons can be articulated, examined, preserved and allowed to shape action. Without those conditions, nursing may remain indispensable to healthcare while its knowledge remains only partially real within the systems that depend on it.

Funding

The authors have nothing to report.

Ethics Statement

The authors have nothing to report.

Conflicts of Interest

The authors declare no conflicts of interest.

Permission to Reproduce Material From Other Sources

Not applicable.

Artificial Intelligence Disclosure

During manuscript preparation, AI was used as an editorial support tool for language editing, condensation, heading adaptation and journal‐format preparation. It was not used to generate the theoretical argument, select references, conduct analysis or determine conclusions. All AI‐assisted text was reviewed, revised and approved by the authors, who take full responsibility for the accuracy, integrity, originality and final content of the manuscript.

Data Availability Statement

No new data were generated or analysed in this conceptual discussion paper. Data sharing is not applicable.