Methods of legitimation: how ethics committees decide which reasons count in public policy decision-making.
In recent years, liberal democratic societies have struggled with the question of how best to balance expertise and democratic participation in the regulation of emerging technologies. This study aims to explain how national deliberative ethics committees handle the practical tension between scientific expertise, ethical expertise, expert patient input, and lay public input by explaining two institutions' processes for determining the legitimacy or illegitimacy of reasons in public policy decision-making: that of the United Kingdom's Human Fertilisation and Embryology Authority (HFEA) and the United States' American Society for Reproductive Medicine (ASRM). The articulation of these 'methods of legitimation' draws on 13 in-depth interviews with HFEA and ASRM members and staff conducted in January and February 2012 in London and over Skype, as well as observation of an HFEA deliberation. This study finds that these two institutions employ different methods in rendering certain arguments legitimate and others illegitimate: while the HFEA attempts to 'balance' competing reasons but ultimately legitimizes arguments based on health and welfare concerns, the ASRM seeks to 'filter' out arguments that challenge reproductive autonomy. The notably different structures and missions of each institution may explain these divergent approaches, as may what Sheila Jasanoff (2005) terms the distinctive 'civic epistemologies' of the US and the UK. Significantly for policy makers designing such deliberative committees, each method differs substantially from that explicitly or implicitly endorsed by the institution.
Ethox Centre, Nuffield Department of Population Health, University of Oxford, UK; Uehiro Centre for Practical Ethics, University of Oxford, UK. Electronic address: kyle.edwards@ethox.ox.ac.uk.
Kyle T
KT
Edwards
D003659:Decision Making, Organizational; D003709:Democracy; D004626:Embryology; D017041:Ethics Committees / Q000458:organization & administration*; D006801:Humans; D011050:Policy Making; D011640:Public Policy; D036301:Qualitative Research; D018456:Reproductive Medicine; D027724:Reproductive Techniques, Assisted; D012955:Societies, Medical / Q000458:organization & administration; D006113:United Kingdom; D014481:United States
Assisted reproductive technologies; Deliberative democracy; Ethics committee; Expertise; Legitimacy; Patient and public involvement; United Kingdom; United States