Achieving epistemic justice in hospitals: Patient expertise through boundary work

Abstract

The crisis of expertise can be acutely felt in healthcare, with new forms of expertise emerging that question the authority of incumbent medical and managerial experts. As part of a response to changing patterns of expertise, healthcare organizations have attempted to foster and include patient expertise as part of the healthcare process. Such initiatives have been touted as promoting epistemic justice, that is, the valuing of knowledge from groups that often have been given less voice. Promoting epistemic justice in healthcare has involved forms of boundary work between medical professionals, administrators and patients, to reconfigure how legitimate knowledge is attributed across diverse actors. Using data from a Patient Partners program of a hospital based in Lyon, we examined how patient knowledge was promoted in a hospital setting. Using the theoretical lens of boundary work and epistemic justice, we examined how groups of experts carried out boundary work that increased porosity of boundaries, augmenting the exchange of information, so that new experts were created—the professional patients, hired by hospitals to improve the emergency care of locals. We discuss the implications for understanding new forms of expertise through boundary work and epistemic justice.