An ethical analysis of policy dialogues.
Deliberation
Ethics
Evidence-informed policy
Knowledge translation
Policy dialogue
Procedural values
Public health
Substantive values
Journal
Health research policy and systems
ISSN: 1478-4505
Titre abrégé: Health Res Policy Syst
Pays: England
ID NLM: 101170481
Informations de publication
Date de publication:
27 Jan 2023
27 Jan 2023
Historique:
received:
18
01
2022
accepted:
13
01
2023
entrez:
28
1
2023
pubmed:
29
1
2023
medline:
1
2
2023
Statut:
epublish
Résumé
A policy dialogue is a tool which promotes evidence-informed policy-making. It involves deliberation about a high-priority issue, informed by a synthesis of the best-available evidence, where potential policy interventions are discussed by stakeholders. We offer an ethical analysis of policy dialogues - an argument about how policy dialogues ought to be conceived and executed - to guide those organizing and participating in policy dialogues. Our analysis focuses on the deliberative dialogues themselves, rather than ethical issues in the broader policy context within which they are situated. We conduct a philosophical conceptual analysis of policy dialogues, informed by a formal and an interpretative literature review. We identify the objectives of policy dialogues, and consider the procedural and substantive values that should govern them. As knowledge translation tools, the chief objective of policy dialogues is to ensure that prospective evidence-informed health policies are appropriate for and likely to support evidence-informed decision-making in a particular context. We identify five core characteristics which serve this objective: policy dialogues are (i) focused on a high-priority issue, (ii) evidence-informed, (iii) deliberative, (iv) participatory and (v) action-oriented. In contrast to dominant ethical frameworks for policy-making, we argue that transparency and accountability are not central procedural values for policy dialogues, as they are liable to inhibit the open deliberation that is necessary for successful policy dialogues. Instead, policy dialogues are legitimate insofar as they pursue the objectives and embody the core characteristics identified above. Finally, we argue that good policy dialogues need to actively consider a range of substantive values other than health benefit and equity. Policy dialogues should recognize the limits of effectiveness as a guiding value for policy-making, and operate with an expansive conception of successful outcomes. We offer a set of questions to support those organizing and participating in policy dialogues.
Sections du résumé
BACKGROUND
BACKGROUND
A policy dialogue is a tool which promotes evidence-informed policy-making. It involves deliberation about a high-priority issue, informed by a synthesis of the best-available evidence, where potential policy interventions are discussed by stakeholders. We offer an ethical analysis of policy dialogues - an argument about how policy dialogues ought to be conceived and executed - to guide those organizing and participating in policy dialogues. Our analysis focuses on the deliberative dialogues themselves, rather than ethical issues in the broader policy context within which they are situated.
METHODS
METHODS
We conduct a philosophical conceptual analysis of policy dialogues, informed by a formal and an interpretative literature review.
RESULTS
RESULTS
We identify the objectives of policy dialogues, and consider the procedural and substantive values that should govern them. As knowledge translation tools, the chief objective of policy dialogues is to ensure that prospective evidence-informed health policies are appropriate for and likely to support evidence-informed decision-making in a particular context. We identify five core characteristics which serve this objective: policy dialogues are (i) focused on a high-priority issue, (ii) evidence-informed, (iii) deliberative, (iv) participatory and (v) action-oriented. In contrast to dominant ethical frameworks for policy-making, we argue that transparency and accountability are not central procedural values for policy dialogues, as they are liable to inhibit the open deliberation that is necessary for successful policy dialogues. Instead, policy dialogues are legitimate insofar as they pursue the objectives and embody the core characteristics identified above. Finally, we argue that good policy dialogues need to actively consider a range of substantive values other than health benefit and equity.
CONCLUSIONS
CONCLUSIONS
Policy dialogues should recognize the limits of effectiveness as a guiding value for policy-making, and operate with an expansive conception of successful outcomes. We offer a set of questions to support those organizing and participating in policy dialogues.
Identifiants
pubmed: 36707839
doi: 10.1186/s12961-023-00962-2
pii: 10.1186/s12961-023-00962-2
pmc: PMC9881302
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
13Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Wellcome Trust
ID : 221503/Z/20/Z
Pays : United Kingdom
Informations de copyright
© 2023. The Author(s).
Références
Health Res Policy Syst. 2003 Jan 13;1(1):2
pubmed: 12646071
BMC Health Serv Res. 2016 Jul 18;16 Suppl 4:220
pubmed: 27454356
BMC Health Serv Res. 2016 Jul 18;16 Suppl 4:216
pubmed: 27454165
BMJ Glob Health. 2020 Apr;4(Suppl 7):
pubmed: 32816823
Health Res Policy Syst. 2018 Nov 20;16(1):113
pubmed: 30458868
Health Res Policy Syst. 2020 Sep 29;18(1):114
pubmed: 32993697
Health Res Policy Syst. 2009 Dec 16;7 Suppl 1:S1
pubmed: 20018099
CMAJ. 2009 Aug 4;181(3-4):165-8
pubmed: 19620273
BMC Public Health. 2019 Dec 19;19(1):1712
pubmed: 31856772
Am J Med. 2020 Nov;133(11):1241-1242
pubmed: 32653419
J Med Ethics. 2009 Jan;35(1):12-6
pubmed: 19103936
Soc Sci Med. 2012 Dec;75(11):1938-45
pubmed: 22938912
BMC Health Serv Res. 2016 Jul 18;16 Suppl 4:219
pubmed: 27454117
Value Health. 2017 Feb;20(2):256-260
pubmed: 28237205
Bull World Health Organ. 2014 Jan 1;92(1):20-8
pubmed: 24391297
Trop Med Int Health. 2018 Oct;23(10):1071-1074
pubmed: 30112816
BMC Health Serv Res. 2016 Jul 18;16 Suppl 4:214
pubmed: 27454450
BMC Health Serv Res. 2016 Jul 18;16 Suppl 4:213
pubmed: 27454227
Am J Public Health Nations Health. 1946 Nov;36(11):1315-23
pubmed: 18016450
Cad Saude Publica. 2019;35(4):e00092918
pubmed: 30994739
Epidemiology. 2020 Mar;31(2):189-193
pubmed: 31809344
J Health Organ Manag. 2012;26(3):293-316
pubmed: 22852453
BMC Health Serv Res. 2016 Jul 18;16 Suppl 4:222
pubmed: 27454448
Health Policy. 2020 Jul;124(7):736-742
pubmed: 32493613
Healthc Policy. 2014 May;9(4):122-31
pubmed: 24973488
BMJ Glob Health. 2017 Dec 7;2(4):e000432
pubmed: 29259821
Health Care Anal. 2017 Dec;25(4):291-307
pubmed: 26170178
Afr J Reprod Health. 2020 Dec;24(4):109-121
pubmed: 34077076
Soc Sci Med. 2014 Dec;123:262-8
pubmed: 25147056
Healthc Policy. 2006 Jan;1(2):59-63
pubmed: 19305655
Health Aff (Millwood). 2000 May-Jun;19(3):236-40
pubmed: 10812803
Int J Health Policy Manag. 2016 Jun 22;5(11):615-618
pubmed: 27801355
Med Health Care Philos. 2018 Sep;21(3):387-402
pubmed: 29124449
Int J Technol Assess Health Care. 2020 Aug 04;:1-8
pubmed: 32746954
Health Promot Perspect. 2015 Jul 07;5(2):104-15
pubmed: 26290826
Qual Health Res. 2015 Nov;25(11):1529-39
pubmed: 25896793
BMC Health Serv Res. 2016 Jul 18;16 Suppl 4:217
pubmed: 27454794
Implement Sci. 2017 Jul 28;12(1):96
pubmed: 28754130
Aust New Zealand Health Policy. 2008 Jul 16;5:16
pubmed: 18631378
BMJ Open. 2019 Jan 17;9(1):e022345
pubmed: 30782678
BMC Health Serv Res. 2016 Jul 18;16 Suppl 4:218
pubmed: 27454907
Patient. 2017 Oct;10(5):545-552
pubmed: 28374286
Health Res Policy Syst. 2016 Apr 21;14:31
pubmed: 27098267
Int J Health Policy Manag. 2017 Jan 22;6(10):601-603
pubmed: 28949475
Int J Technol Assess Health Care. 2016 Jan;32(1-2):10-5
pubmed: 27472157
BMC Public Health. 2014 Dec 17;14:1287
pubmed: 25516355
Philos Public Aff. 1997 Fall;26(4):303-50
pubmed: 11660435
Health Res Policy Syst. 2020 Oct 31;18(1):127
pubmed: 33129335
Am J Public Health. 2001 Nov;91(11):1776-82
pubmed: 11684600
Bull World Health Organ. 2014 Jun 1;92(6):389
pubmed: 24940009
Am J Public Health. 2008 Sep;98(9):1573-7
pubmed: 18633088
J Med Ethics. 2009 May;35(5):274-5
pubmed: 19407029
Health Res Policy Syst. 2009 Dec 16;7 Suppl 1:S14
pubmed: 20018104
Health Care Anal. 2021 Mar;29(1):39-58
pubmed: 33341924
Health Res Policy Syst. 2016 Oct 18;14(1):78
pubmed: 27756401