McMaster University Ringgold Standard Institution - Political Science, 1280 Main St West Hamilton, Hamilton, OntarioL8S 4L8, Canada.
Health Econ Policy Law. 2021 Oct;16(4):424-439. doi: 10.1017/S1744133121000013. Epub 2021 Feb 9.
How do experts judge the legitimacy of technical policy processes, and do their ideas change as these processes are opened to other stakeholders and the public? This research examines the adoption of public and patient involvement in pharmaceutical assessment in Canada. It finds tensions between scientific legitimacy that prioritizes rigor and objectivity, and democratic legitimacy that values inclusion and a broader range of evidence. In response to policy change, experts incorporate new ideas about democratic inputs and processes, while maintaining scientific policy goals. The research responds to calls for more precise measurement of ideas and ideational change and more evaluation of public and patient involvement in health policy. It helps us understand the significance of, and limits to, ideational change among experts in health policy domains that are highly technical and publicly salient. Understanding the way democratic and scientific legitimacy are negotiated in policy decisions has a wide applicability in health, but is particularly relevant during a global pandemic when evidence is being generated rapidly, decisions must be made quickly, and these decisions have a significant, immediate effect on the lives of all citizens.
专家如何判断技术政策过程的合法性，以及随着这些过程向其他利益相关者和公众开放，他们的想法是否会发生变化？本研究考察了在加拿大采用公众和患者参与药物评估的情况。研究发现，科学合法性优先考虑严谨性和客观性，而民主合法性则重视包容性和更广泛的证据，这两者之间存在紧张关系。为了应对政策变化，专家们在坚持科学政策目标的同时，纳入了关于民主投入和程序的新想法。该研究回应了更多精确衡量理念和观念变化以及更多评估公众和患者参与卫生政策的呼吁。它帮助我们理解在高度技术性和公众关注的卫生政策领域，专家们的观念变化的意义和局限性。在卫生领域，理解民主和科学合法性在政策决策中的协商方式具有广泛的适用性，但在全球大流行期间尤为相关，因为证据正在迅速产生，必须迅速做出决策，这些决策对所有公民的生活都有重大和直接的影响。
