Citizen deliberation in setting health-care priorities.

Abstract

Citizen deliberation is a prominent theme in health policy literature. It is believed that citizens who deliberate may influence the setting of public health-care priorities. Currently, in some jurisdictions, citizens are members of community health boards, and thus have a forum to articulate and share values that could affect the reduction of health inequalities within their communities. However, there is little conceptual clarity on the character of citizen deliberation, or, more specifically, how citizens may articulate and share values. This paper reviews the literature on citizen deliberation in setting health-care priorities; discusses potential challenges for citizens in setting health-care priorities; outlines a developing theory of citizen deliberation; describes how citizens may articulate and share values that ground their health-care priorities and outlines implications of a developing theory of citizen deliberation, its relevance to UK study findings, and to community health boards in setting health-care priorities. As members of community health boards, citizens can evaluate their subjective experiences. In reasoning about embedded values, citizens may gain insight into the kind of community they aspire to be, and, in that process, examine their intentions, including whether to serve self or other(s). Citizens who articulate and share values such as respect, generosity or equity may justify health-care priorities that create opportunities for all community members to gain mastery over their lives.