Why and When Should We Use Public Deliberation?

Solomon, Stephanie; Abelson, Julia

doi:10.1002/hast.27

Cited by 83 publications

(81 citation statements)

References 13 publications

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“…It follows that in a medical ethics perspective public deliberation, meaning medical deliberation, could be a solution. This kind of method is particularly appealing when there are apparently irreconcilable moral perspectives-for instance with regard to euthanasia-nevertheless, there is a common will to reach a consensus [40]. By consensus it is meant not the consensual resolution of a particular ethical dilemma but a consensus regarding the way physicians should individually deliberate and decide.…”

Section: Resultsmentioning

confidence: 99%

Euthanasia: A Challenge to Medical Ethics

Nunes¹,

Rêgo²

2016

J Clin Res Bioeth

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Section: Resultsmentioning

confidence: 99%

Euthanasia: A Challenge to Medical Ethics

Nunes¹,

Rêgo²

2016

J Clin Res Bioeth

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“…We found that civil society is limited in Health Councils throughout Brazil by restrictive membership guidelines, a lack of autonomy from the government, vulnerability to government manipulation, a lack of support and recognition from the government, and a lack of necessary training and budget [6, 29]. As a result of these issues, Health Councils may not be an effective forum through which civil society can engage in discussion to promote policy that is reflective of societal needs.…”

Section: Discussionmentioning

confidence: 99%

“…On a similar note, terms like ‘engagement’, ‘participation’ and ‘involvement’ are used often without an explicit explanation of the degree to which civil society will be engaged in decision-making or the roles and expectations of civil society participants [6, 27, 28]. Governments rarely specify how and when civil society’s views and demands will be included in the policy and decision-making process [29]. This lack of clarity suggests the need to understand better the strengths and weaknesses of how current participatory policy models are designed so that future efforts incorporate lessons [9, 30].…”

Section: Introductionmentioning

confidence: 99%

Civil society participation in the health system: the case of Brazil’s Health Councils

Martinez

Köhler

2016

Global Health

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BackgroundBrazil created Health Councils to bring together civil society groups, heath professionals, and government officials in the discussion of health policies and health system resource allocation. However, several studies have concluded that Health Councils are not very influential on healthcare policy. This study probes this issue further by providing a descriptive account of some of the challenges civil society face within Brazil’s Health Councils.MethodsForty semi-structured interviews with Health Council Members at the municipal, state and national levels were conducted in June and July of 2013 and May of 2014. The geographical location of the interviewees covered all five regions of Brazil (North, Northeast, Midwest, Southeast, South) for a total of 5 different municipal Health Councils, 8 different state Health Councils, and the national Health Council in Brasilia. Interview data was analyzed using a thematic approach.ResultsHealth Councils are limited by a lack of legal authority, which limits their ability to hold the government accountable for its health service performance, and thus hinders their ability to fulfill their mandate. Equally important, their membership guidelines create a limited level of inclusivity that seems to benefit only well-organized civil society groups. There is a reported lack of support and recognition from the relevant government that negatively affects the degree to which Health Council deliberations are implemented. Other deficiencies include an insufficient amount of resources for Health Council operations, and a lack of training for Health Council members. Lastly, strong individual interests among Health Council members tend to influence how members participate in Health Council discussions.ConclusionsBrazil’s Health Councils fall short in providing an effective forum through which civil society can actively participate in health policy and resource allocation decision-making processes. Restrictive membership guidelines, a lack of autonomy from the government, vulnerability to government manipulation, a lack of support and recognition from the government and insufficient training and operational budgets have made Health Council largely a forum for consultation. Our conclusions highlight, that among other issues, Health Councils need to have the legal authority to act independently to promote government accountability, membership guidelines need to be revised in order include members of marginalized groups, and better training of civil society representatives is required to help them make more informed decisions.

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“…Deliberative methods offer policymakers the promise of greater transparency and public accountability. Policies formed through public participation in deliberative processes can be considered to be more legitimate, justifiable, and, therefore, feasible than policies made through more traditional hierarchical modes of governance (Davies et al, 2006;Solomon & Abelson, 2012). What distinguishes deliberative methods from other forms of public engagement is a process of iterative two-way dialogue between representatives of the public and the deliberation sponsor (researchers, government or other agencies).…”

Section: Introductionmentioning

confidence: 99%

Which public and why deliberate? – A scoping review of public deliberation in public health and health policy research

Degeling

Carter

Rychetnik

2015

Social Science & Medicine

169

176

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Deliberative methods are of increasing interest to public health researchers and policymakers. We systematically searched the peer-reviewed literature to identify public health and health policy research involving deliberative methods and report how deliberative methods have been used. We applied a taxonomy developed with reference to health policy and science and technology studies literatures to distinguish how deliberative methods engage different publics: citizens (ordinary people who are unfamiliar with the issues), consumers (those with relevant personal experience e.g. of illness) and advocates (those with technical expertise or partisan interests). We searched four databases for empirical studies in English published 1996-2013. This identified 78 articles reporting on 62 distinct events from the UK, USA, Canada, Australasia, Europe, Israel, Asia and Africa. Ten different types of deliberative techniques were used to represent and capture the interests and preferences of different types of public. Citizens were typically directed to consider community interests and were treated as a resource to increase democratic legitimacy. Citizens were preferred in methodological studies (those focused on understanding the techniques). Consumers were directed to focus on personal preferences; thus convened not as a source of policy decisions, but of knowledge about what those affected by the issue would accept. Advocates-who are most commonly used as expert witnesses in jurieswere sometimes engaged to deliberate with consumers or citizens. This almost always occurred in projects directly linked to policy processes. This suggests health policymakers may value deliberative methods as a way of understanding disagreement between perspectives. Overall however, the 'type' of public sought was often not explicit, and their role not specified. This review provides new insight into the heterogeneity and rising popularity of deliberative methods, and indicates a need for greater clarity regarding both the constitution of publics and the relative usefulness of different deliberative techniques.

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Why and When Should We Use Public Deliberation?

Cited by 83 publications

References 13 publications

Euthanasia: A Challenge to Medical Ethics

Euthanasia: A Challenge to Medical Ethics

Civil society participation in the health system: the case of Brazil’s Health Councils

Which public and why deliberate? – A scoping review of public deliberation in public health and health policy research

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