Abstract
This chapter discusses the use of deliberative processes in policy making about bioethics, drawing more broadly on deliberative democracy theory and health policy. We discuss who runs deliberative processes and why, but are particularly concerned with what conditions are needed for deliberative processes to be successful. We note uncertainties and tensions that may be inevitable in meeting these conditions. Fairness and accountability emerge as themes in which these conditions can be grouped. For accountability in particular, understanding the policy context and motives for deliberative processes are essential to their evaluation.
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References
Abelson, J. 2003. Does deliberation make a difference? Results from a citizens panel study of health goals priority setting. Health Policy 66(1): 95–106.
Abelson, J., M. Giacomini, P. Lehoux, and F.-P. Gauvin. 2007. Bringing ‘the public’ into health technology assessment and coverage policy decisions: From principles to practice. Health Policy 82(1): 37–50.
Anand, P. 2002. Public health: Decision-making when science is ambiguous. Science 295(5561): 1839.
Arrow, K.J. 1977. Current developments in the theory of social choice. Social Research 44(4): 607–622.
Bernert, C. 1983. The career of causal analysis in American sociology. The British Journal of Sociology 34(2): 230–254.
Bishop, P., and G. Davis. 2002. Mapping public participation in policy choices. Australian Journal of Public Administration 61(1): 14–29.
Bowie, C., A. Richardson, and W. Sykes. 1995. Consulting the public about health service priorities. British Medical Journal 311(7013): 1155–1158.
Bruni, R.A., A. Laupacis, and D. Martin. 2008. Public engagement in setting priorities in health care. Canadian Medical Association Journal 179(1): 15–18.
Chilvers, J. 2008. Deliberating competence: Theoretical and practitioner perspectives on effective participatory appraisal practice. Science Technology Human Values 33(2): 155–185.
Collins, R. 1989. Sociology: Proscience or antiscience? American Sociological Review 54(1): 124–139.
Contandriopoulos, D. 2004. A sociological perspective on public participation in health care. Social Science and Medicine 58(2): 321–330.
Daniels, N. 2000. Accountability for reasonableness. British Medical Journal 321(7272): 1300–1301.
Daniels, N., and J. Sabin. 1997. Limits to health care: Fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philosophy and Public Affairs 26(4): 303–350.
Delli Carpini, M., F. Cook, and L. Jacobs. 2004. Public deliberation, discursive participation, and citizen engagement: A review of the empirical literature. Annual Review of Political Science 7(1): 315–344.
Dixon, J., and H.G. Welch. 1991. Priority setting: Lessons from Oregon. The Lancet 337(8746): 891–894.
Dolan, P., R. Cookson, and B. Ferguson. 1999. Effect of discussion and deliberation on the public’s views of priority setting in health care: focus group study. British Medical Journal 318(7188): 916–919.
Dyer, C. 2007. NICE faces legal challenge over Alzheimer’s drug. British Medical Journal 334(7595): 654–655.
Fiorino, D. 1990. Citizen participation and environmental risk: A survey of institutional mechanisms. Science Technology Human Values 15(2): 226–243.
Gibson, J., D. Martin, and P. Singer. 2005. Priority setting in hospitals: Fairness, inclusiveness, and the problem of institutional power differences. Social Science & Medicine 61(11): 2355–2362.
Goldthorpe, J.H. 2001. Causation, statistics, and sociology. European Sociological Review 17(1): 1–20.
Knight, J., and J. Johnson. 1997. What sort of political equality does deliberative democracy require? In Deliberative democracy: Essays on reason and politics, ed. J. Bohman and W. Rehg, 279–320, Cambridge: The MIT Press.
Laird, F. 1993. Participatory analysis, democracy, and technological decision making. Science Technology Human Values 18(3): 341–361.
Lenaghan, J. 1999. Involving the public in rationing decisions. The experience of citizens juries. Health Policy 49(1–2): 45–61.
Lenaghan, J., B. New, and E. Mitchell. 1996. Setting priorities: Is there a role for citizens’ juries? British Medical Journal 312(7046): 1591–1593.
Litva, A. 2002. “The public is too subjective”: Public involvement at different levels of health-care decision making. Social Science and Medicine 54(12): 1825–1837.
Martin, D., J. Abelson, and P. Singer. 2002. Participation in health care priority-setting through the eyes of the participants. Journal of Health Services Research and Policy 7(4): 222–229.
Milewa, T. 2006. Health technology adoption and the politics of governance in the UK. Social Science and Medicine 63(12): 3102–3112.
Mitton, C., N. Smith, S. Peacock, B. Evoy, and J. Abelson. 2009. Public participation in health care priority setting: A scoping review. Health Policy 91(3): 219–228.
Morrell, M. 2005. Deliberation, democratic decision-making and internal political efficacy. Political Behavior 27(1): 49–69.
Nagel, J. 1992. Combining deliberation and fair representation in community health decisions. University of Pennsylvania Law Review 140(5): 1965–1985.
Newman, J., M. Barnes, H. Sullivan, and A. Knops. 2004. Public participation and collaborative governance. Journal of Social Policy 33(02): 203–223.
O’Doherty, K., and M. Burgess. 2009. Engaging the public on biobanks: Outcomes of the BC biobank deliberation. Public Health Genomics 12(4): 203–215.
O’Donnell, M., and V. Entwistle. 2004. Consumer involvement in decisions about what health-related research is funded. Health Policy 70(3): 281–290.
Peacock, S., C. Mitton, A. Bate, B. McCoy, and C. Donaldson. 2009. Overcoming barriers to priority setting using interdisciplinary methods. Health Policy 92(2–3): 124–132.
Pötter, U., and H.-P. Blossfeld. 2001. Causal inference from series of events. European Sociological Review 17(1): 21–32.
Powell, M., and M. Colin. 2009. Participatory paradoxes: Facilitating citizen engagement in science and technology from the top-down? Bulletin of Science Technology Society 29(4): 325–342.
Quennell, P. 2003. Getting a word in edgeways? Patient group participation in the appraisal process of the National Institute for Clinical Excellence. Clinical Governance: An International Journal 8(1): 39–45.
Rayner, S. 2003. Democracy in the age of assessment: reflections on the roles of expertise and democracy in public-sector decision making. Science and Public Policy 30(3): 163–170.
Rawls, J. 1999. A theory of justice. Cambridge: Harvard University Press.
Renn, O., T. Webler, and P. Wiedemann. 1995. The pursuit of fair and competent citizen participation. In Fairness and competence in citizen participation: Evaluating models for environmental discourse, ed. O. Renn, T. Webler, and P. Wiedemann, 339–367, Dordrecht: Kluwer Academic Publishers.
Rowe, G., and L. Frewer. 2000. Public participation methods: A framework for evaluation. Science Technology Human Values 25(1): 3–29.
Rowe, G., and L. Frewer. 2004. Evaluating public-participation exercises: A research agenda. Science Technology Human Values 29(4): 512–556.
Rowe, G., and L. Frewer. 2005. A typology of public engagement mechanisms. Science Technology Human Values 30(2): 251–290.
Sabik, L., and R. Lie. 2008. Priority setting in health care: Lessons from the experiences of eight countries. International Journal for Equity in Health 7(1): 4.
Santos, S., and C. Chess. 2003. Evaluating citizen advisory boards: The importance of theory and participant-based criteria and practical implications. Risk Analysis 23(2): 269–279.
Sellars, C., and A. Easey. 2008. First successful legal challenge to NICE guidance. Journal of Intellectual Property Law Practice 3(11): 692–694.
Stewart, D., P. Shamdasani, and D. Rook. 2007. Focus groups: Theory and practice (Applied social research methods). London: Sage Publications.
Tenbensel, T. 2002. Interpreting public input into priority-setting: the role of mediating institutions. Health Policy 62(2): 173–194.
Webler, T. 1995. “Right” discourse in citizen participation: an evaluative yardstick. In Fairness and competence in citizen participation: Evaluating models for environmental discourse, ed. O. Renn, T. Webler, and P. Wiedemann, 35–86. Dordrecht: Kluwer Academic Publishers.
Young, I. 1990. Justice and the politics of difference. Princeton: Princeton University Press.
Acknowledgments
This research was conducted as part of Australian Research Council Discovery Project Grant “Big Picture Bioethics: Policy-making and Liberal Democracy” (DP0556068).
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Smith, C., Rowe, G. (2016). Deliberative Processes in Practice. In: Dodds, S., Ankeny, R. (eds) Big Picture Bioethics: Developing Democratic Policy in Contested Domains. The International Library of Ethics, Law and Technology, vol 16. Springer, Cham. https://doi.org/10.1007/978-3-319-32240-7_5
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DOI: https://doi.org/10.1007/978-3-319-32240-7_5
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