Degeling Chris, Carter Stacy M, Rychetnik Lucie
The Centre for Values, Ethics and the Law in Medicine, The University of Sydney, Australia.
The Centre for Values, Ethics and the Law in Medicine, The University of Sydney, Australia.
Soc Sci Med. 2015 Apr;131:114-21. doi: 10.1016/j.socscimed.2015.03.009. Epub 2015 Mar 6.
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 juries-were 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.
审议方法越来越受到公共卫生研究人员和政策制定者的关注。我们系统地检索了同行评审文献，以确定涉及审议方法的公共卫生和卫生政策研究，并报告审议方法的使用情况。我们应用了一种参考卫生政策以及科技研究文献制定的分类法，以区分审议方法如何与不同的公众群体互动：公民（不熟悉相关问题的普通人）、消费者（有相关个人经历，如患病经历的人）和倡导者（有技术专长或党派利益的人）。我们在四个数据库中搜索了1996年至2013年发表的英文实证研究。这确定了78篇文章，报道了来自英国、美国、加拿大、澳大拉西亚、欧洲、以色列、亚洲和非洲的62个不同事件。使用了十种不同类型的审议技术来代表和捕捉不同类型公众的利益和偏好。公民通常被引导去考虑社区利益，并被视为增加民主合法性的一种资源。在方法学研究（那些侧重于理解技术的研究）中更倾向于纳入公民。消费者被引导关注个人偏好；因此召集他们不是作为政策决策的来源，而是作为了解受该问题影响的人会接受什么的知识来源。倡导者——最常被用作陪审团专家证人的群体——有时会与消费者或公民一起参与审议。这种情况几乎总是发生在与政策过程直接相关的项目中。这表明卫生政策制定者可能重视审议方法，将其作为理解不同观点之间分歧的一种方式。然而总体而言，所寻求的公众“类型”往往不明确，其角色也未明确规定。本综述为审议方法的异质性和日益普及提供了新的见解，并表明需要在公众构成以及不同审议技术的相对有用性方面更加明确。
