Deliberative methods:engaging citizens in collective decision-makingANDREW THOMPSON

UNIVERSITY OF EDINBURGH

Conflicts of interest Who has paid you to give talks?

◦ My university pays my salary and my travel/subsistence costs

Who has paid you for advice?◦ No one

Who has funded your research?◦ My university through my salary

Who has paid for you to attend conferences?◦ My university

Any other interest that could be connected with your work?◦ None, apart from academic

Context Government to governance legitimacy and authority complexity stakeholder involvement better decision-making?

Current practice in learning from citizens surveys of opinions and evaluations of services patient /carer stories / emotional touch points focus groups membership of committees / fora

largely reactive and individualised

Definitions Mini-publics (Dahl, 1989): assemblies of citizens, demographically representative of the larger population, brought together to learn and deliberate on a topic to inform public opinion and decision-making

Deliberation involves talk to resolve political conflict and problem-solving, through arguing, demonstrating, expressing and persuading, rather than suppression, oppression, or thoughtless neglect. (Mansbridge et al, 2012)

Two principles (Parkinson, 2004):

1. Reasoning between people, rather than bargaining between competing interests

2. A public act, rather than a private act (such as voting)

Purpose in decision-making From: consumers shopping in the market of ideas through pre-formed individual preferences often uninformed or unconsidered reactions

To: citizens negotiating the meaning of the public good through democratic and rational processes more reflective engagement through learning, talking and

listening

Stages of mini-publics1. Planning and recruitment

stewarding committee (neutral and opposing views) random and/or purposive selection

2. Learning information sources and materials witnesses/experts/activists/officials/politicians

3. Deliberation small groups, face-to-face

4. Decision-making reasoned recommendations or decisions

5. Follow-up dissemination of outputs and outcomes

Characteristics of participants Participants in mini-publics are (typically): randomly selected to give everyone affected an equal chance of selection

stratified to reflect a diverse range of socio-demography and any other pertinent

characteristics remunerated exposed to differing viewpoints enabled to cross-examine experts (partisan and non-partisan) supported in all stages of the process by non-partisan facilitators

Forms of deliberationMini publics Citizen juries Planning cells Consensus

conferencesDeliberative polls

Citizen assemblies

No. of citizens 12-26 100-500 10-18 100-500 103-160

No. of meetings

2-5 days 4-5 days 7-8 days 2-3 days 20-30 days

Sampling Random Random Random + self-selection

Random Random + self-selection

Result Collective position report

Survey opinions + collective position report

Collective position report

Survey opinions Detailed policy recommend-ations

Destination Sponsor + mass media

Sponsor + mass media

Parliament + mass media

Sponsor + mass media

Government + public referendum

Source: adapted from Elstub and McLaverty (2014).

Advantages Allows citizens the time and resources to learn and to deliberate to reach an informed decision Learn how citizens produce informed decisions and what affects their preferences Engages and empowers citizens to take an active part in decisions that affect them and their communities Places citizens in realistic dynamic and collective contexts, rather than artificial individual isolation

Challenges Reflecting the population of interest equity; diversity; involving the uninvolved

Inclusion of the activists Prevention of agency capture by vested interests Mitigating information bias (materials, media, experts) Outputs are usually recommendations, not decisions accountability to participants for outcome

Scaling-up / developing infrastructure

Impact Public policy

involvement of ‘ordinary’ citizens (the ‘wise fool’ rather than the engaged activist) rational process, rather than vested interests testing arguments at the micro level before being made at the macro level opportunities for learning new ways of working for all stakeholders

Participants increased self-efficacy and empowerment in making complex decisions

Citizens more generally seen by other citizens to offer proxies for the ‘general public’ (themselves)

Governance can be combined with other forms of involvement/participation, including representation increased legitimacy of decisions

Summary Suited to complex and contentious problems Generally seen as acceptable methods by citizens A degree of independence from vested interests Increased reliability and validity of opinions and decisions

Time consuming Expensive Experts and sponsors can manipulate participants Usually one-off events, rather than continuous review

References Dahl R (1989). Democracy and its critics. New Haven, Yale University Press.

Elstub S and McLaverty P (eds) (2014). Deliberative democracy: issues and cases. Edinburgh: Edinburgh University Press.

Fishkin J (2009). When the people speak: deliberative democracy and public consultation. Oxford: Oxford University Press.

Mansbridge J, Bohman J, Chambers S, Christiano T, Fung A, Parkinson J, Thompson DF and Warren ME (2012). A systemic approach to deliberative democracy. In: Parkinson J and Mansbridge J (eds), Deliberative Systems: deliberative democracy at the large scale. Cambridge: Cambridge University Press.

Parkinson J (2004). Why deliberate? The encounter between deliberation and the new public managers. Public Administration, 82 (2), 377-395.

Potential contributions to health care

Abelson J, Forest P-G, Eyles J, Smith P, Martin E and Gauvin F-P (2003). Deliberations about deliberative methods: issues in the design and evaluation of public participation processes. Social Science & Medicine, 57, 239–251.

Gregory J, Hartz-Karp J and Watson R (2008). Using deliberative techniques to engage the community in policy development. Australia & New Zealand Health Policy, 5: 16.

Carman KL, Heeringa JW, Heil SKR, Garfinkel S, Windham A, Gilmore D, Ginsburg M, Sofaer S, Gold M and Pathak-Sen E (2013). Public deliberation to elicit input on health topics: findings from a literature review. Executive summary. Publication No. EHC 13-070-EF-1. Rockville, MD: Agency for Healthcare Research and Quality.

Questions?

If you wish to continue the conversation, contact me at:

andrew.thompson@ed.ac.uk