Democratising health policy with deliberative mini-publics: Responsibilities, pathologies, and paradoxes
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by
Catherine Settle, University, The Australian National, University, The Australian National
2017
Abstract
Throughout the last couple of decades there has been an unprecedented level of global interest in democratically-deliberative methods of citizen engagement [now collectively referred to as deliberative mini-publics - hereafter, mini-publics]. Part of the allure of mini-publics is that they provide a more meaningful and effective way for governments to exchange knowledge and engage in decision-making with their citizens. Mini-publics are also known to generate transformative insights for citizens and government decision-making bodies; demonstrated in the shifting of pre-formed preferences, the creation of shared understanding, and collective decision-making. What this transformative potential might have to offer for citizens when they deliberate on health policy has not been fully explored, however, especially in Australian health policy settings where these engagement techniques are quite novel, with very little known of citizens' experiences of deliberating and exchanging knowledge in such circumstances. For instance, it is not really known whether an exchange of knowledge even occurs, let alone, whether a just exchange occurs. This cross-disciplinary, qualitative research reduces this gap in knowledge and demonstrates how the competing rationalities of the health policy process and the product-dominant logic within health service delivery exacerbate the challenges facing health policy administrators as they grapple with the unfamiliar nature of mini-publics. Many unintentional consequences with disabling outcomes for citizens' experiences of exchanging knowledge and expressing their deliberative capacities ensue. Two types of epistemic injustice also became apparent: testimonial injustice, during which the citizens were not given credibility in their capacity to convey information; and hermeneutical injustice whereby the citizens were not given credibility in their capacity to understand certain things that would be in their best interests to understand. So what do these things matter when citizens deliberate o [...]
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Date 2017-11-08
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