Maintaining the Divide: The Legitimate Role for the Public in Health and Science Policymaking

Area of Science:

• Public Policy
• Health Policy
• Science Policy

Background:

• Policy decisions on health, science, and emerging technologies (e.g., AI, pandemics, climate change) involve complex moral and prudential value disagreements.
• Proceduralism is a common framework for navigating these disagreements in collective decision-making.
• However, policy choices also involve descriptive questions, distinct from normative ones, requiring different justification standards.

Purpose of the Study:

• To critique the adequacy of proceduralism in health and science policy-making.
• To propose a more nuanced and epistemically informed account of legitimate decision-making.
• To redefine the role of public participation in health and science policy.

Main Methods:

• Conceptual analysis of proceduralism and its application to policy-making.
• Distinction between normative and descriptive questions in policy contexts.
• Epistemic evaluation of decision-making frameworks.

Main Results:

• Proceduralism is insufficient as a complete framework for legitimate decision-making when both normative and descriptive questions are involved.
• A new account of legitimate decision-making is offered, emphasizing epistemic considerations.
• The public's role should be central in normative decisions but limited in policy-relevant descriptive inquiries.

Conclusions:

• Existing proceduralist approaches fail to fully account for the complexities of health and science policy, particularly the distinction between normative and descriptive elements.
• An epistemically informed framework offers a more robust model for legitimate policy decisions.
• Public engagement should be strategically focused on value-based (normative) aspects, rather than factual (descriptive) determinations in policy.