Can We Trust "Democratic Deliberation"?(Essay‪)‬

Anumber of bioethicists strongly advocate a mechanism known as "rational democratic deliberation" for addressing in a way that is fair and legitimate some of the controversial ethical and policy issues related to medicine and health care policy. I am among them. Unfortunately, whether and how deliberative outcomes can actually alter public policy is not quite clear. Many will recognize the public educational value of deliberative efforts but stop far short of holding that they should have a direct and substantial role in shaping public policy. To my mind, Fukuyama and Furger are committed to only a minimalist conception of democratic deliberation. They are correct to doubt the commitment of scientists and industry leaders in reprogenetics to self-regulation. But they are excessively skeptical of the public's capacity to engage in fair and reasonable deliberations about these matters. They would welcome public input through Web-based citizen panels and very broad surveys, but they would filter the results of this input through a special reprogenetics advisory board and other standard regulatory mechanisms, which suggests they do not regard the public input as being either trustworthy or sufficiently accountable.