Intended for healthcare professionals

Rapid response to:

Editor's Choice

At your next conference ask where the patients are

BMJ 2016; 354 doi: (Published 22 September 2016) Cite this as: BMJ 2016;354:i5123

Rapid Response:

More than patient-centred care, patient expertise

Godlee’s appreciative appraisal of patient involvement in medical knowledge building strikes me positively at a time when my professional cohort in science studies is scaling back on previous intellectual development and promotion of “lay expertise”—the valuable experience-based insight that non-professionals can bring to complex science policy debates. With seeming political paralysis on climate change in the US and frustrating vaccine hesitancy and resistance by some of the public throughout the industrialized North, some scholars are taking pause and asking if the democratization of expertise has been taken too far [1].

Instead professional barriers (like expensive conferences) limit communication and meaningful exchange. Tokenism suggests lay perspectives are marginally tolerated. All this goes to show that non-expert contributions to the professions had not been given fair opportunity before professional frustration surfaced.

Professional reluctance to engage with non-experts also misunderstands the nature of complex policy and practice decisions, which involve multiple stakeholders who experience the impacts differently. If clinical research settled health care practice questions definitively, then there might be an argument for limiting the sphere of expertise. But healthcare does not meet that standard, and so diverse contributions to the knowledge base, risk assessment, and practical implication are strongly justified and warranted. I am encouraged to see calls for more non-expert involvement rather than less, as well as efforts to detail how these exchanges can be most fruitful.

[1] Collins, H. 2014. Are We All Scientific Experts Now? London: Polity.

Competing interests: No competing interests

30 September 2016
Maya J. Goldenberg
Associate Professor of Philosophy
University of Guelph
Department of Philosophy, University of Guelph