V. Public debate that counts
For public debate In this document and in Article 28 of the Oviedo Convention the overarching concept of ‘public debate’ is used to describe discursive interactions in the public sphere (that is, not in a professional context) through which individuals and groups may identify, explore and resolve their different interests in matters that affect (or potentially affect) them all. to make a difference there needs to be a functional connection between public debate and the governance In this guide ‘governance’ means the accountable use of power or authority to set, monitor, and enforce standards and behaviours within systems or organisations. It can mean both steering people’s behaviour and ensuring that they are held to account. Governance can be given effect through compulsory and non-compulsory measures (legal provision, licensing systems, professional norms, codes of conduct, recommendations etc.,). Governance can be a function of both public and private actors. of health care and biomedicine, so that the public are empowered to influence the conditions of their collective future in a way that is appropriate in a democratic society.
The previous section concerned the quality of the public debate activity An organised activity, delimited in scope, intended to stimulate and to attend to public debate on a specific theme in the expectation that it will inform or influence policy development or governance. itself; this section concerns its further impacts and how to optimise them. These further impacts are of two sorts: direct effects (for example, giving rise to new policies) and increasing the integrity of the public as a social body and, therefore, the capacity of the public to participate in governance through democratic processes.
For public debate to be effective, it is important that both participants Public authorities, experts and citizens all may be regarded as participants in a public engagement activity or debate. and those initiating public debate activities are committed to the process. On the part of the initiator the person who takes the initiative in a public debate activity. The initiator will usually provide or co-ordinate the resources for the activity and may commission specialists to facilitate or deliver the activity on their behalf., this stake is demonstrated by support for the process of public debate and by taking account of the outcome. From the outset, there should be transparency about how an initiative is expected to relate to the matters under consideration, what other measures may be possible (or not possible) and what account participants and the wider public can expect to receive of this. In turn, the participants are likely to be more committed to the process when they know that their engagement counts.
Initiators of public debate may benefit from face-to face encounters with other participants in a public debate. Participants could, for instance, be invited to present the outcome of discussions to initiators and to discuss how they propose to take forward the issues discussed.
Commitment may be demonstrated by the initiator of public debate activities by setting out explicitly what is open for debate (and what is not open for debate, and why) and what influence public debate is expected to have.
Understanding and mutual trust between participants and initiators, for example between publics and public authorities, may be improved by face-to-face encounters.
There is an implicit obligation on any democratic state to take the interests of its public into account and to demonstrate how it has done this by accounting for its decisions. Those responsible for initiating public debate activities should provide feedback on what conclusions they have drawn from the public debate and how the views of publics Many social scientists and public engagement practitioners prefer the plural term ‘publics’ to the singular ‘public’ to avoid implying the existence of a single homogeneous group or that ‘the public’ has objective existence independently of the issues in question. were taken into consideration, for example in subsequent policy-making and/or other related decisions or processes. This information can be conveyed for example via websites and public media.
Accountability may be demonstrated by publishing information about the ways in which public debate has informed decisions or practices.
Reporting back to the participants of a public debate can help to encourage future participation and to break down barriers between publics and public authorities.
Publishing and disseminating information about a public debate activity, for example in the form of a description of the proceedings and a summary of the outcome, can help to secure wider impact and consolidate a foundation for further debate.See Portugal and France examples
The process and the outcome of public debate activities should be evaluated. Confidence in the good faith of the initiators of public debate activities can be assured by engaging an independent and skilled evaluator who has access to the whole process. The evaluator should ideally be appointed during the planning/commissioning stage. At the very least, those initiating the debate could publish their reflections on the activities so that others are able to review and discuss it.
Evaluation should address the effectiveness of the activity (see section on ‘Effective public debate’ above) as well as how well the activity met the aims and expectations of participants and initiators, including a reflection on the added value of the public contribution.
The outcome of the evaluation should be made public in accordance with the principle of transparency, so that all interested parties, not only the participants, can be informed about the activity and to encourage further public debate and provide a reference point for further activities.
Setting criteria, measures and a framework for evaluation at the outset and, so far as possible, agreeing these with participants at an early stage promotes confidence in the integrity of the public debate process.
Evaluation of the public debate process can be supported by feedback from participants (collected, for example, by a questionnaire at public events or by the inclusion of suitable questions as part of the process).
Depending on the nature of the process, evaluators might seek to inform their conclusions by undertaking qualitative interviews with participants.
Continuing public debate
Public debate should ideally contribute to socially constructive discourse that is reflected in the decisions and policy making of governments and public authorities. An experience of effective debate can also help to foster political engagement on the part of the public and positive social interaction more generally.
Furthermore, through the process of engagement, participants may find that they develop considerable expertise in relation to certain issues. For example, networks and connections developed through participation in public debate activities might lead to involvement in further initiatives.
Continuing public debate is valuable in monitoring and evaluating the implications of policy decisions, invigorating the public sphere The space of public debate; a notional communicative environment in which private individuals can formulate and discuss societal challenges that affect them in common and influence policy. In practice, it may be supported by institutions, such as social and political institutions, and the media. and building capacity and confidence that can carry through into future engagements.
Public debate in a specific context may give rise to further opportunities for continuing the involvement of participants.
Aside from the legacy of connection among people and between publics, relevant experts and professionals, and public authorities, public debate may also generate tangible social resources in the form of records of events and reference documents on which future debate can build.See Portugal, France and Russian Federation examples
Embedding public debate on bioethics
A society in which the habits of democratic participation are established through education and opportunities for public participation will be better prepared to engage the public on questions of the governance of biological and biomedical developments.
Assigning specific responsibilities to institutions to support public debate, such as national ethics committees, independent organisations, public authorities, regulators or advisory committees, can help to promote public debate, maintain a continual level of public involvement with developments in biomedicine and provide institutional mechanisms to support public debate in practice.
This continuing process can help to bridge the gap between social norms, which are rarely examined, and the need to address urgent policy questions arising in relation to new biological and biomedical developments.
Institutions such as those mentioned above can help to promote a culture of public debate and public participation by being alert to pockets of relevant discourse within society, being open to engaging with these, and facilitating the connection of these debates with each other and with relevant stakeholders and policy makers.
In a culture of public debate, these institutions could welcome and benefit from uninvited and ‘bottom-up’ interventions as well as planned public debate activities.
Adequately resourced and politically supported national ethics committees or similar bodies can have an important role in fostering public debate, in carrying out public debate activities when needed, and in securing the impact of public debate.See France example See Denmark and Cyprus examples
The public debate on End of Life resulted in the publication of a book “Deciding on the end of life – cycle of debates” which contained a collection of excerpts of conferences including interventions from the public. It also included a glossary and a conclusion with the main questions and arguments presented in the debate as well as a short study on comparative legislation.
The debate on End of Life did not lead to changes in Portuguese legislation, but the documentation in the form of a book serves as a record and reference point for future debates on the topic.
The “États Généraux” was carefully analysed afterwards by the National Consultative Ethics Committee (CCNE) which, in June 2018, published a summary report outlining in addition the opinions formulated by the Citizen’s Committee in the outcome of the initiative.
The French National Consultative Ethics Committee (CCNE) recommended in its Opinion 129, issued in September 2018, that the French law on bioethics is supported by ongoing public debate on bioethical issues and is not carried out as a ‘one-time’ event. The aim is to foster a culture of debate on these issues. In this context, the report by the CCNE will most likely serve as an important reference point for the future.
In the “États Généraux” a key to the successful involvement of the public was the mandate given to the National Consultative Ethics Committee (CCNE) to foster public debate and organise the activities it considered appropriate. The CCNE was given this broader mandate in 2011, and funding was secured for the revision of the law on bioethics in 2018.
The Danish Board of Technology was previously funded by the Danish government but is now an independent institution which is no longer publicly funded. It was considered important to detach it from the government; however, it does not have a mandate stipulated by law and thus works on a commission basis.
Russian Federation - Public debate and its impact on the law on transplantation of human organs and tissues (2016)
The public discussion on the suggested amendments to the law "on transplantation of human organs and tissues" confirmed that organ donation is a very sensitive issue in Russian society. The suggested amendments were met by substantial criticism from the public. One of the most important lessons learned is that the debate will only be effective if people have a full understanding of the subject, especially when the subject raises human rights issues.
- I. Guide to Public Debate on Human Rights and Biomedicine
- II. The need for public debate
- III. Preparing for public debate
- IV. Effective public debate
- V. Public debate that counts
- VI. Conclusions
- Examples of public debate
- Selected resources