Recommendations from Two Citizens’ Juries on the Surgical Management of Obesity
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It is important that guidelines and criteria used to prioritise access to bariatric surgery are informed by the values of the tax-paying public in combination with the expertise of healthcare professionals. Citizens’ juries are increasingly used around the world to engage the public in healthcare decision-making. This study investigated citizens’ juries about prioritising patient access to bariatric surgery in two Australian cities.
The objective of this study is to examine public priorities for government expenditure on the surgical management of obesity developed through either a one or three-day citizen jury.
A three-day jury was held in Brisbane and a one-day jury in Adelaide. Jurors were selected in Brisbane (n = 18) and in Adelaide (n = 12) according to pre-specified criteria. Expert witnesses from various medical disciplines and consumers were cross-examined by jurors.
The verdicts of the juries were similar in that both juries agreed bariatric surgery was an important option in the management of obesity and related comorbidities. Recommendations about who should receive treatment differed slightly across the juries. Both juries rejected the use of age as a rationing tool, but managed their objections in different ways. Participants’ experiences of the jury process were positive, but our observations suggested that many variables may influence the nature of the final verdict.
Citizen’s juries, even when shorter in duration, can be an effective tool to guide the development of health policy and priorities. However, our study has identified a range of variables that should be considered when designing and running a jury and when interpreting the verdict.
KeywordsCitizen council Decision-making Public engagement Obesity management
The authors gratefully acknowledge the valuable input from all the expert witnesses, stakeholders, the jurors and the input from Debbie Cowan of Queensland Health for her work in facilitating engagement with Queensland Health. We also thank Kylie Rixon, Cassandra Ranatunga and the expert facilitators—Mr. Max Hardy of Max Hardy Consulting, Melbourne Australia and Ms. Danielle Annells of Danielle Annells Consulting Sydney Australia.
Compliance with Ethical Standards
This project was approved by the Griffith University Human Research Ethics Committee (Ref: MED/09/13/HREC) and the Metro South Hospital and Health Service Research Ethics Committee (Ref: HREC/12/QPAH/330). Informed consent was obtained from all individual participants included in the study.
Conflicts of Interest
The authors declare that they have no conflict of interest.
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