Governance practices in transition and clients as epistemic agents
The rise of the expertise by experience is expected to strengthen a shift from the hierarchical governance towards self-organization and autonomy of clients and their equal partnerships with social and health care professionals. Through the system of the expertise by experience the citizens’ role as a service provider is growing in Finland because the current policy demands their active engagement in the production of social and health care services. The objectives directed towards engaging the citizens are written into the Finnish policy programs and strategies, which emphasize the importance of experiential expertise. However, the experts by experience consider themselves more as objects of governmental control than as independent subjects.
The research aims at finding answers to the question on how institutional authority in the practices of social and healthcare deal with their clients as epistemic agents. Many individuals in socially vulnerable position are underestimated regarding their capabilities of acquiring information relevant to the society. Fo instance, people with substance abuse problems do not necessarily have the words and appropriate concepts to describe their own experiences.
The research data include interviews of experts by experience and social and health care professionals, video-recorded rehabilitation sessions and audio-recorded meetings including clients, experts by experience and professionals. The interviewed experts by experience create a picture of society where there is good will and intention to develop alternative forums for civic activity. However, this is empty rhetoric with no real import. Applying the philosopher Miranda Fricker’s concepts of epistemic injustice we analyse this data. The structures of social and health service system do not sufficiently support the status of experts by experience. Still, we argue that implicit knowledge of expert by experiences can function as an alternative for declarative knowledge, questioning and complementing educated expertise in social and health care.
Publications
Auvinen, P., Parviainen, J., Lahikainen, L. & Palukka, H. (2021) Discussion protocol for alleviating epistemic injustice: The case of community rehabilitation interaction and female substance abusers. Social Sciences 10(2), 45; https://doi.org/10.3390/socsci10020045