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05/27/2015

Lessons from Democratic Deliberations

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) launched its discussion about democratic deliberation in bioethics this morning by focusing on how to connect theory to practice. The Bioethics Commission heard from James Fishkin, Ph.D., the Janet M. Peck Professor of International Communication and director of the Center for Deliberative Democracy at Stanford University, and Scott Kim, M.D., Ph.D., a senior investigator in the Department of Bioethics at the National Institutes of Health.

Fishkin has worked extensively to apply the theory of democratic deliberation to create informed public policy discussions. During this morning’s session, Fishkin shared his experience conducting 70 democratic deliberation polls in 22 countries, most recently in Tanzania. He explained that he combines a random sampling of the public with specific conditions designed to facilitate free and respectful group deliberation.

In Tanzania, for example, Fishkin worked with the government to recruit 400 citizens to attend a two-day educational meeting, where they were briefed extensively on natural gas policy and participated in group discussions. They were polled both before and after the meeting. Results showed that attending the meeting significantly affected their views.

Fishkin explained that simply giving people information is not sufficient to engage them on a policy issue. Open discussion among people of diverse viewpoints in an environment of mutual respect is essential, he said.

“Democratic deliberation is not populism,” Fishkin said. “Democratic deliberation is an attempt to convene the people under conditions where they really think about the tradeoffs and competing values.”

Kim noted that measuring public values on moral and ethical issues—including bioethical issues—is challenging. He described how he and his colleagues applied democratic deliberation to assess public opinion on surrogate decision-making by family members of people with Alzheimer’s disease.

Similar to what Fishkin found, Kim said that participating in democratic deliberation had a strong effect on people’s views.

“The process is seen as fair and trustworthy by participants,” Kim said. Indeed, he noted that people who participated in democratic deliberation said that they were willing to abide by the group’s decision, even if it did coincide with their personal views.

Up next, the Bioethics Commission will discuss democratic deliberation in bioethics at the national level.

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