Philosophical Ethics helping to understand Questions related to Expertise-by-Experience in the Field of Social and Health Care?

Teksti | Karoliina Nikula

In this article I ponder if philosophical thinking could help understand the complex ethical questions related to Expertise-by-Experience (EBE). I introduce two theories that would require deeper thinking and at the end I bring up two concepts that could perhaps help to understand the EBE phenomenon better. Both the theories mentioned, and the concepts brought up in the article would demand deep analytical thinking and further studies.

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Philosophical thinking as a starting point

An important task for a philosopher is to question ordinary ways of thinking. Philosophical statements are not infallible or definitive, but a kind of milestone. (Niiniluoto 1984, 10). Philosophy is based on critical thinking and debate. It does not consist of ready-made and final knowledge, but of a constant effort to clarify, structure and re-evaluate concepts and ideas (Niiniluoto 1984, 66-67). The task of philosophy is to formulate concepts more precisely, to outline the overall understanding, and to provide a deeper explanation for incompletely understood things. (Niiniluoto & Haaparanta 1990, 91-94.)

Philosophy can be described as the science of problems and arguments rather than the science of answers. (Niiniluoto 1984, 10). According to Niiniluoto, the critical task of philosophy is to analyze and critique the preconditions, content, and effects of all forms of human culture. (Niiniluoto 1984, 61). When philosophy seeks new results, a way of thinking which can be thought of as problematization, explication, and argumentation is usually applied. (Niiniluoto 1984, 62).

Expertise-by-Experience with Social Ethical Lenses

According to Meriluoto (2018, 12) expert-by-experience is a term that is “used to refer to people who have undergone problematic experiences in their past and have then been invited to act as experts based on those experiences in social welfare and healthcare organisations”. Referring to Tieteen Termipankki (2022), social ethics can be described as applied ethics that is interested of issues of social justice and equality. Pruuki (2007, 21) states that, social ethics is interested in choices, values, communities, and ethics of society. Social ethics can be said to be particularly interested in concepts. Concepts can be used as a tool to specify and understand morally relevant issues within communities (; see also Nikula 2023, Nikula 2024).

In a previous article (Expertise-By-Experience as a Social Ethical Question in the Social and Health Care Sector | Laurea Journal) I named some points how expertise-by-experience can be seen as a social ethical question within the social and health care sector. Those were e.g. 1) the complex EBE concept(s) itself, that is not settled. It is not always clear what is meant by expertise-by-experience, 2) lack of well-established ethical code of conduct in the EBE field, 3) The EBE-educational field being wide and vague, 4) the question of actual power of EBEs existing or not 5) are traditional professionals prepared well enough to utilize experiential knowledge offered in their field and so on. Even though EBEs have been around for couple decades, literature on ethical questions regarding EBE activities remain sparse (Nikula & Rajamäki 2019; Ristolainen 2017, 16; Nikula 2024,).

Philosophical theories as tools

There is a saying that nothing is as practical as a good theory. Philosophical ethics and perhaps particularly social ethical approach (see e.g. Nikula 2024) and theories could help to understand some of the ethical issues related to EBEs. Theoretical frameworks often applied within social ethics, like the ethics of collective action (yhdessä toimimisen etiikka) and action theory (toiminnan teoria) could be helpful (Hallamaa 2017; Tuomela 1977).

The ethics of collective action (Hallamaa 2017) could be an essential framework because experiential expertise is related to the relationships between different actors in various work environments and beyond. The ethics of collective action expands the traditional discussion related to ethics by examining precisely the interagency between individuals. The theory also aids in understanding power dynamics, influence, and decision-making (Hallamaa 2017). Action theory is crucial because in expertise-by-experience in the social and healthcare sector, it concerns human action. An actor can be defined as someone who has 1) the ability to set goals, 2) an understanding of cause-and-effect relationships and the ability to evaluate them, 3) the ability to pursue set goals through their actions (Tuomela 1977).

Working together and collective action is demanding. There can be different dimensions to working together: peerness, partnership, benefit, or client/patient-professional, etc. To say what good collaboration there is between EBEs, clients/patients, professionals, and decision-makers, it is first necessary to find out under what conditions can we talk about co-operation in general in terms of expertise-by-experience and on what grounds can one be called good (moral and ethically sustainable). (Hallamaa 2017). Recognizing the other as an equal actor can sometimes be difficult in practice. The theory and conceptual examination of the ethics of working together helps us understand, for example, influencing and exercising power in working together, what shared expertise is (Hallamaa 2017, 222).

Multilateral reciprocity (monenkeskinen vastavuoroisuus) requires that one’s own and another’s role be taken seriously (Hallamaa 2017, 282). This may sound easy, but for psychological reasons it is not. Human beings naturally seek support for their own thoughts. A critical appraisal of one’s own views requires one’s own views to be questioned. Recognition of the capacity of the other presupposes giving space to the other in such a way that he himself relinquishes control, manoeuvring and dictation. (Hallamaa 2017, 282).


EBE ethics surely needs wider research and discussion. Clearer understanding of the ethics of EBEs will make it easier to justify and defend their wider use in the social and health care sector. The theories mentioned in the article, the ethics of working together and action theory would require more systematic thinking and deeper studying.

I stated above that social ethics is especially interested in concepts. The concept of EBE could perhaps be seen in a different light. It might be worth asking is the expert concept the best to describe what it is all about. I also stated in the beginning, that philosophy can be described as the science of problems and arguments rather than the science of answers. I will now conclude this article by bringing up a question and wondering if the concepts of wisdom and understanding could help to understand the true nature of expertise-by-experience (see also Nikula 2024b). That is a question that would take entire research article and concept analysis to even try to find an answer.


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