What role should philosophy play in community-based health services?

Community-Based Work and Participatory Budgeting

Participatory budgeting (PB) works best if this activity is viewed to be part of a trend that is referred to as community-based work. But this connection is not often made. As a result, many PB projects tend to drift away from their home communities. Although working in communities is thought to be a very practical endeavor, philosophy should not be ignored, particularly if the aim is to be community-based. Some examples are supplied in this paper that illustrate how this community-based philosophy alters, and improves, some traditional phases of PB projects. The overall result is to keep these budgeting projects informed by local knowledge and under community control.

[Not Available]

There is now broad agreement that ideas like person-centred care, patient expertise and shared decision-making are no longer peripheral to health discourse, fine ideals or merely desirable additions to sound, scientific clinical practice. Rather, their incorporation into our thinking and planning of health and social care is essential if we are to respond adequately to the problems that confront us: they need to be seen not as "ethical add-ons" but core components of any genuinely integrated, realistic and conceptually sound account of healthcare practice. This, the tenth philosophy thematic edition of the journal, presents papers conducting urgent research into the social context of scientific knowledge and the significance of viewing clinical knowledge not as something that "sits within the minds" of researchers and practitioners, but as a relational concept, the product of social interactions. It includes papers on the nature of reasoning and evidence, the on-going problems of how to 'integrate' different forms of scientific knowledge with broader, humanistic understandings of reasoning and judgement, patient and community perspectives. Discussions of the epistemological contribution of patient perspectives to the nature of care, and the crucial and still under-developed role of phenomenology in medical epistemology, are followed by a broad range of papers focussing on shared decision-making, analysing its proper meaning, its role in policy, methods for realising it and its limitations in real-world contexts.