When Hospitals Join the Community: Practical Considerations and Ethical Frameworks

Written from the perspective of hospitals, this article examines, in theory and in practice, challenges associated with hospitals’ efforts to engage in neighborhood development more fully with the communities that neighbor them. Increasingly, these efforts include significant investments in housing, safety, and educational initiatives. These investments stretch the traditional expertise of medical practitioners and administrators and raise ethical and political questions about how best to engage and work with communities. After first describing the contexts within which hospital-community relationships arise, we examine ethical and political considerations likely to bear on the success of these projects. We conclude with recommendations to hospitals for operating within communities in a way that is consistent with hospitals’ ethical commitments.