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Equity, Participation, and Power

Achieving Health Justice Through Deep Democracy

Published online by Cambridge University Press:  01 January 2021

Abstract

This article explores how health governance has evolved into an enormously complicated—and inequitable and exclusionary—system of privatized, fragmented bureaucracy, and argues for addressing these deficiencies and promoting health justice by radically deepening democratic participation to rebalance decision-making power. It presents a framework for promoting four primary outcomes from health governance: universality, equity, democratic control, and accountability, which together define health justice through deep democracy. It highlights five mechanisms that hold potential to bring this empowered participatory mode of governance into health policy: participatory needs assessments, participatory human rights budgeting, participatory monitoring, public health care advocates, and citizen juries.

Type
Symposium Articles
Copyright
Copyright © American Society of Law, Medicine and Ethics 2020

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References

For definitions and discussion of accountability, see Brinkerhoff, D.W., “Accountability and Health Systems: Toward Conceptual Clarity and Policy Relevance,” Health Policy and Planning 19, no. 6 (2004): 371379; Institute of Development Studies, “Making Accountability Count,” IDS Policy Briefing 33 (2006); S. Van Belle and S.H. Mayhew, “What Can We Learn on Public Accountability from Non-Health Disciplines: A Meta-Narrative Review,” BMJ Open 6, no. 7 (2016).CrossRefGoogle ScholarPubMed
I draw this simple four-point framework from several complementary models: the grassroots Healthcare Is a Human Right framework developed by the Vermont Workers’ Center and Partners for Dignity & Rights, the health justice framework developed by Lindsay Wiley and other scholars, the capabilities framework articulated by Amartya Sen and Martha Nussbaum, and international human rights law (particularly the Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights, and Declaration on the Right to Development).Google Scholar
See, for example, Arias, E.and Xu, J., “United States Life Tables, 2017,” National Vital Statistics System 68, no. 7 (2019); R. Chetty, M. Stepner, S. Abraham S, et al., “The Association Between Income and Life Expectancy in the United States, 2001-2014,” JAMA 315, no. 16 (2016): 1750–1766; E.S. LeCounte and G.R. Swain, “Life Expectancy at Birth in Milwaukee County: A Zip Code-Level Analysis,” Journal of Patient-Centered Research and Reviews 4, no. 4 (2017): 213-220.Google ScholarPubMed
S.R. Collins, H.K. Bhupal, and M.M. Doty, “Health Insurance Coverage Eight Years After the ACA: Fewer Uninsured Americans and Shorter Coverage Gaps, But More Underinsured,” Commonwealth Foundation, Survey Brief (2019); L. Saad, “More Americans Delaying Medical Treatment Due to Cost,” Gallup, December 9, 2019, available at <https://news.gallup.com/poll/269138/americans-delaying-medical-treatmentdue-cost.aspx> (last viewed May 16, 2020).+(last+viewed+May+16,+2020).>Google Scholar
See, for example, Mansbridge, J., “Rethinking Representation,” The American Political Science Review 97, no. 4 (2003): 515528; M. Gilens and B.I. Page, “Testing Theories of American Politics: Elites, Interest Groups, and Average Citizens,” Perspectives on Politics 12, no. 3 (2014): 564–581 (on the theories of representative government); P. Drahos, ed., Regulatory Theory: Foundations and Applications (Acton, Australia: ANU Press, 2017) (on theories of regulatory governance).CrossRefGoogle Scholar
Gilens, M., “Inequality and Democratic Responsiveness,Inequality and Democratic Responsiveness, 69, no. 5 (2005): 778796, at 778.Google Scholar
See Gilens and Page, supra note 5, at 564; see also Miler, K.C., Poor Representation: Congress and the Politics of Poverty in the United States (Cambridge: Cambridge University Press, 2018).CrossRefGoogle Scholar
Simonovits, G., Guess, A.M., and Nagler, J., “Responsiveness without Representation: Evidence from Minimum Wage Laws in U.S. States,” American Journal of Political Science 63, no. 2 (2019): 401410.CrossRefGoogle Scholar
See, for example, Harvey, D., A Brief History of Neoliberalism (Oxford: Oxford University Press, 2007): at 3.Google Scholar
D. Levi-Faur, “Regulatory Capitalism,” in Drahos, P., ed., Regulatory Theory, 1st ed. (Acton, Australia: ANU Press, 2017): 289302; D. Levi-Faur, “Regulatory Capitalism and the Reassertion of the Public Interest,” Policy and Society 27, no. 3 (2009): 181–191; J. Braithwaite, “Neoliberalism or Regulatory Capitalism,” Regulatory Institutions Network, RegNet Occasional Paper No. 5 (October 2005). Michael Power similarly describes an “audit explosion,” Mimi Abramovitz and Jennifer Zelnick describe a culture of marketized, financialized “managerialism.” Kimberly Morgan and Andrea Louise Campbell describe “delegated governance,” and Steven Kent Vogel describes a regime of “reregulation.” See M. Power, “The Audit Society - Second Thoughts,” International Journal of Auditing 4, no. 1 (2000): 111–119; M. Abramovitz and J. Zelnick, “The Logic of The Market versus The Logic of Social Work: Whither the Welfare State?” Social Work & Society 16, no. 2 (2018); K.J. Morgan and A.L. Campbell, The Delegated Welfare State: Medicare, Markets, and the Governance of Social Policy (New York: Oxford University Press, 2011), 4-5; S.K. Vogel, Freer Markets, More Rules: Regulatory Reform in Advanced Industrial Countries (Ithaca, NY: Cornell University Press, 1996).CrossRefGoogle Scholar
A.K. Hoffman, “Health Care's Market Bureaucracy,” University of Pennsylvania Law School, Public Law and Legal Theory Research Paper Series Research Paper No. 19-28 (2019): at 6.Google Scholar
Hoffman, id., at 7-8.Google Scholar
Fraser, N., “Rethinking the Public Sphere: A Contribution to the Critique of Actually Existing Democracy,” Social Text 25/26 (1990): 5680; M.T. McCluskey, “Deconstructing the State-Market Divide: The Rhetoric of Regulation from Workers Compensation to the World Trade Organization,” in M. Fineman and T. Dougherty, eds., Feminism Confronts Homo Economicus (Ithaca, NY: Cornell University Press, 2018): 147–174; S. Mettler, “Reconstituting the Submerged State: The Challenges of Social Policy Reform in the Obama Era,” Perspectives on Politics 8, no. 03 (September 2010): 803–824.CrossRefGoogle Scholar
Rahman identifies privatization, fragmentation, and bureaucratic exclusion as the three core “exclusionary strategies … through which law constructs … inequality via the maladministration of public goods.” See Rahman, K.S., “Constructing Citizenship: Exclusion and Inclusion through the Governance of Basic Necessities,” Columbia Law Review 118, no. 8 (2018): 22472504, at 2247.Google Scholar
See, for example, Cornwall, A.and Coelho, V.S.P., “Spaces for Change? The Politics of Participation in New Democratic Arenas,” in Cornwall, A.and Coelho, V.S.P., eds., Spaces for Change? The Politics of Citizen Participation in New Democratic Arenas (New York: Zed Books, 2007): 129, at 10-11; Fineman, M.A., “The Vulnerable Subject: Anchoring Equality in the Human Condition,” Yale Journal of Law and Feminism 20, no. 1 (2008): 1-23, at 7-8.Google Scholar
For discussion of domination and vulnerability frameworks, see Rahman, K.S., Democracy Against Domination (New York: Oxford University Press, 2017); M.A. Fineman, “The Vulnerable Subject: Anchoring Equality in the Human Condition,” Yale Journal of Law and Feminism 20, no. 1 (2008): 1–23; Y. Dawood, “The Antidomination Model and the Judicial Oversight of Democracy,” Georgetown Law Journal 96, no. 5 (June 2008): 1411–1485.CrossRefGoogle Scholar
See, for example, Brown, W., Undoing the Demos: Neoliberalism's Stealth Revolution, First Edition (New York: Zone Books, 2015).CrossRefGoogle Scholar
On broader regimes of disciplinary control, see, for example, Rahman (2018), supra note 14, and the work of V. Eubanks, D. W. Garland, P. Herd and D. P. Moynihan, M.B. Katz, T. Mahmud, M. M. Ngai, M. Pavlovskaya, F. Fox Piven, and R. Cloward, S. F. Schram, J. Soss, D. Spade, and L. Wacquant.Google Scholar
See, for example, Banerjee, A.and Armstrong, P., “Centring Care: Explaining Regulatory Tensions in Residential Care for Older Persons,” Studies in Political Economy 95, no. 1 (2015): 728 (on the “neoliberal auditing” culture that has developed in nursing-home regulation in Ontario, with clear parallels to the U.S.); L.P. Casalino, S. Nicholson, D.N. Gans, T. Hammons, D. Morra, T. Karrison, and W. Levinson, “What Does It Cost Physician Practices To Interact With Health Insurance Plans?” Health Affairs 28, no. 4 (2009): w533–43 (finding that physicians spend three hours per week interacting with health plans and nurses and administrative staff spend another 19.1 hours per physician).CrossRefGoogle Scholar
For discussion of the exclusionary complexity and inscrutability of health care bureaucracy, see Hoffman, supra note 11, and Morone, J.A., “The Health Care Bureaucracy: Small Changes, Big Consequences,” Journal of Health Politics, Policy and Law 18, no. 3 (1993): 723739.CrossRefGoogle ScholarPubMed
I use the term “citizen-resident” to emphasize that in referring to citizens, I mean to include all residents of the United States as members of the democratic polity whether or not someone has formal citizenship status, is of voting age, or has had their voting rights stripped because of a criminal conviction. Wherever I refer to citizens and citizenship, I intend this broad definition.Google Scholar
See Wiley, L.F., “From Patient Rights to Health Justice: Securing the Public's Interest in Affordable, High-Quality Health Care,” Cardozo Law Review 37, no. 37 (2016): 833899; Cornwall and Coelho, supra note 15; Hoffman, supra note 11.Google Scholar
Rahman, K.S., “Envisioning the Regulatory State: Technocracy, Democracy, and Institutional Experimentation in the 2010 Financial Reform and Oil Spill Statutes Democracy,” Harvard Journal on Legislation 48, no. 2 (2011): 555–90, at 586.Google Scholar
See Cuellar, M-F., “Rethinking Regulatory Democracy,” Administrative Law Review 57, no. 2 (2005): 411499, at 497-498. (“The vast majority of regulatory questions simply cannot be resolved without making value choices and policy trade-offs. Any narrative of regulatory activity eliding those components of regulatory decisionmaking is misleading.”)Google Scholar
See, for example, Bagley, N.and Revesz, R.L., “Centralized Oversight of the Regulatory State,” Columbia Law Review 106 (2006): 12601329.Google Scholar
See Rahman (2019), supra note 16, at 24-25; Dowdle, M.W., “Public Accountability: Conceptual, Historical and Epistemic Mappings,” in Dragos, P., ed., Regulatory Theory, 1st Edition, (Acton, Australia: ANU Press, 2017): 197215.CrossRefGoogle Scholar
See Rahman (2011), supra note 23, at 586 (“Democracy inheres, then, not in the sovereignty of the atomized voter as a bearer of preferences and values, but in the organization of individuals into groups of shared values, interests, and aspirations.”); Rahman (2017), supra note 16.; K.Rahman, S.and Gilman, H.R., Civic Power: Rebuilding American Democracy in an Era of Crisis, 1st ed. (Cambridge: Cambridge University Press, 2019); Cornwall and Coelho, supra note 15; L.F. Wiley, “Health Law as Social Justice,” Cornell Journal of Law and Public Policy 24, no. 1 (2014): 47–105.CrossRefGoogle Scholar
See Cornwall and Coelho, supra note 15. 29. Fung, A.and Wright, E. O., “Thinking about Empowered Participatory Governance,” in Fung, A.and Wright, E. O., eds., Deepening Democracy: Innovations in Empowered Participatory (London: Verso, 2003): 342.Google Scholar
See Rahman and Gilman, supra note 27.Google Scholar
Rahman, K.S., “Policymaking as Power-Building,” Southern California Interdisciplinary Law Journal 27 (2018): 315–77.Google Scholar
Thorpe, J.and J. Gaventa, “Democratising Economic Power: The Potential for Meaningful Participation in Economic Governance and Decision-Making,” Institute of Development Studies, IDS Working Paper (2020).Google Scholar
Freeman, J., “Collaborative Governance in the Administrative State,” UCLA Law Review 45, no. 1 (1997): 198.Google Scholar
Ruger, J.P., “Shared Health Governance,” The American Journal of Bioethics 11, no. 7 (2011): 3245.CrossRefGoogle ScholarPubMed
I.E. Sandoval-Ballesteros, “From ‘Institutional’ to ‘Structural’ Corruption: Rethinking Accountability in a World of Public-Private Partnerships,” Edmond J. Safra Working Papers No. 33 (2013).CrossRefGoogle Scholar
Melish, T.J., “Maximum Feasible Participation of the Poor: New Governance, New Accountability, and a 21st Century War on the Sources of Poverty,Maximum Feasible Participation of the Poor: New Governance, New Accountability, and a 21st Century War on the Sources of Poverty, 13, no. 1 (2010): 1133.Google Scholar
Akuno, K., “The Jackson-Kush Plan: The Struggle for Black Self-Determination and Economic Democracy,” (2012), available at <http://navigatingthestorm.blogspot.com/2012/05/the-jackson-kush-plan-and-struggle-for.html> (last visited August 23, 2020).+(last+visited+August+23,+2020).>Google Scholar
Praxis Project, “Centering Community in Public Health: Measuring the Impact of Building Community Power for Health Justice: What? Why? And How?” (2020), available at <https://www.thepraxisproject.org/resource/2020/measuring-impact-of-building-community-power> (last visited August 23, 2020).+(last+visited+August+23,+2020).>Google Scholar
Healthcare Is a Human Right Collaborative, “Our Movement,” available at <http://healthcareisahumanright.org/about/> (last viewed May 15, 2020); A Rudiger, “The Vermont Model: NESRI Case Study on the Healthcare Is a Human Right Movement,” National Economic and Social Rights Initiative (2011), available at <https://dignityandrights.org/2011/08/the-vermont-model-nesri-case-study-on-the-healthcare-is-ahuman-right-movement/> (last visited July 9, 2020).+(last+viewed+May+15,+2020);+A+Rudiger,+“The+Vermont+Model:+NESRI+Case+Study+on+the+Healthcare+Is+a+Human+Right+Movement,”+National+Economic+and+Social+Rights+Initiative+(2011),+available+at++(last+visited+July+9,+2020).>Google Scholar
C. Albisa and B. Palmquist, “A New Social Contract: Collective Solutions Built by and for Communities,” National Economic and Social Rights Initiative (2018).Google Scholar
See, for example, Sanders, L. M., “Against Deliberation,” Political Theory 25, no. 3 (1997): 347376; Cornwall and Coelho, supra note 15; Fraser, supra note 13. For a discussion of complementary approaches between deliberative and nondeliberative approaches, see J. Mansbridge et al., “The Place of Self-Interest and the Role of Power in Deliberative Democracy,” Journal of Political Philosophy 18, no. 1 (2010): 64–100.CrossRefGoogle Scholar
For discussion of CAAs, CAPs, and the OEO, see Melish, supra note 36, at 23-30.Google Scholar
Melhado, E.H., “Health Planning in the United States and the Decline of Public-Interest Policymaking,” The Milbank Quarterly 84, no. 2 (2006): 359440, at 380-385.CrossRefGoogle ScholarPubMed
Morone, J.A., The Democratic Wish: Popular Participation and the Limits of American Government, Revised Edition (New Haven: Yale University Press, 1998), at 271285.Google Scholar
See Melish, supra note 36, at 23-30; Melhado, supra note 44, at 380-385; Morone (1998), id., at 271-285.Google Scholar
Rahman and Gilman, supra note 27, at 150-168.Google Scholar
Israel, B.A. et al., “Review of Community-Based Research: Assessing Partnership Approaches to Improve Public Health,” Annual Review of Public Health 19, no. 1 (1998): 173202.CrossRefGoogle ScholarPubMed
Kasdan, A., Marotta, P., and Hamburg, A., “Beyond Methadone: Improving Health and Empowering Patients in Opioid Treatment Programs,” VOCAL-NY and Community Development Project of the Urban Justice Center (2011).Google Scholar
Centers for Disease Control and Prevention, Health Impact Assessment, available at <https://www.cdc.gov/healthyplaces/hia.htm> (last visited May 15, 2020).+(last+visited+May+15,+2020).>Google Scholar
Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 et seq. (2010).Google Scholar
Internal Revenue Service, Department of the Treasury, “Community Health Needs Assessments for Charitable Hospitals,” 26 CFR Parts 1 and 53, REG-106499-12, RIN 1545-BL30 (April 5, 2013).Google Scholar
The ACA, for example, simply requires that a CHNA “takes into account input” from communities, and lets hospitals choose patient representatives. Hospitals are given the sole power to determine what questions to ask, what documentation methods to use, how to interpret and report findings, how to prioritize various community health needs, and how to formulate a plan for meeting community health needs. Guidance on HIAs from the National Association of County and City Health Officials and other bodies is similarly vague, suggesting that an HIA “considers input from stakeholders” and “should involve and engage the public, and inform and influence decision-makers.” See Patient Protection and Affordable Care Act, supra note 50; National Association of County and City Health Officials, Health Impact Assessment, available at <https://www.naccho.org/programs/community-health/healthy-community-design/health-impact-assessment> (last visited May 15, 2020); National Conference of State Legislatures, Health Impact Assessments, available at <https://www.ncsl.org/research/health/health-impact-assessments.aspx> (last visited May 15, 2020); Health Impact Project, “Health Impact Assessment Legislation in the States” (2015), available at <https://www.pewtrusts.org/∼/media/assets/2015/01/hia_and_legislation_issue_brief.pdf> (last visited July 9, 2020).+(last+visited+May+15,+2020);+National+Conference+of+State+Legislatures,+Health+Impact+Assessments,+available+at++(last+visited+May+15,+2020);+Health+Impact+Project,+“Health+Impact+Assessment+Legislation+in+the+States”+(2015),+available+at++(last+visited+July+9,+2020).>Google Scholar
Dannenberg, A. L., Bhatia, R., Cole, B. L., Heaton, S. K., Feldman, J. D., and Rutt, C. D., “Use of Health Impact Assessment in the U.S.,” American Journal of Preventive Medicine 34, no. 3 (2008): 241256.CrossRefGoogle ScholarPubMed
Fung, A., “Varieties of Participation in Complex Governance,” Public Administration Review 66, no. s1 (2006): 6675, at 70.CrossRefGoogle Scholar
See National Conference of State Legislatures and Health Impact Project, supra note 52.Google Scholar
See Rudiger, A.and Meier, B.M., “A Rights-Based Approach to Health Reform,” in Beracochea, E., Weinstein, C., and Evans, D.P., eds., Rights-Based Approaches to Public Health (New York: Springer Publishing Company, 2010), 6986.; Rudiger, A., Ten Health Care Financing Principles to Ensure Universality, Equity, and Accountability (National Economic and Social Rights Initiative, March 2009).Google Scholar
Vermont Workers’ Center (VWC) & National Economic and Social Rights Initiative (NESRI), “Public Participation in Vermont's Budget and Revenue Policies,” Background Paper (2012), available at <https://dignityandrights.org/resources/proposal-for-public-participation-in-state-budget-and-revenue-policy/> (last visited July 9, 2020); Vermont Workers’ Center, “Proposal for Public Participation in State Budget & Revenue Policy,” (2012), available at <https://dignityandrights.org/resources/proposal-for-public-participation-instate-budget-and-revenue-policy/> (last visited July 9, 2020).+(last+visited+July+9,+2020);+Vermont+Workers’+Center,+“Proposal+for+Public+Participation+in+State+Budget+&+Revenue+Policy,”+(2012),+available+at++(last+visited+July+9,+2020).>Google Scholar
See, for example, Fox, D.M. and Leichter, H.M., “Rationing Care in Oregon: The New Accountability,” Health Affairs 10, no. 2 (1991): 727; J. Oberlander, T. Marmor, and L. Jacobs, “Rationing Medical Care: Rhetoric and Reality in the Oregon Health Plan,” Canadian Medical Association Journal 164, no. 11 (2001): 1583–1587; Office of Technology Assessment, United States Congress, Evaluation of The Oregon Medicaid Proposal (1992).CrossRefGoogle ScholarPubMed
Participatory Budgeting Project, “Where is PB Happening?” available at <https://www.participatorybudgeting.org/casestudies/> (last visited May 12, 2020).+(last+visited+May+12,+2020).>Google Scholar
Baiocchi, G., “Participation, Activism, and Politics: The Porto Alegre Experiment,” in Fung, A.and Wright, E. O., eds., Deepening Democracy: Innovations in Empowered Participatory (London: Verso, 2003): 4576.Google Scholar
Coelho, V.S.P., “Brazil's Health Councils: The Challenge of Building Participatory Political Institutions,” IDS Bulletin 35, no. 2 (2004): 3339.CrossRefGoogle Scholar
See VWC and NESRI (2012) and VWC (2012), supra note 57.Google Scholar
See VWC and NESRI (2012), supra note 57, at 7.Google Scholar
CT Gen Stat § 38a-47 and § 38a-48 (2012).Google Scholar
J. Colon, “Introducing Participatory Budgeting to Public Health Departments,” The Public Health National Center for Innovations, February 21, 2018, available at <https://phnci.org/journal/introducing-participatory-budgeting-to-publichealth-departments> (last visited May 15, 2020).+(last+visited+May+15,+2020).>Google Scholar
Although public officials are charged with holding private actors to account, opening the theoretical possibility for citizens to indirectly hold private actors by threatening to vote elected officials out of office unless they crack down on abusive industries, the chain of accountability from citizens to elected officials to appointed regulators to private industries is often too long and fragile to uphold democratic accountability.Google Scholar
Participatory monitoring has also been used employed widely in human rights law and development in the global South. South Africa's Human Rights Commission is perhaps the most famous example.Google Scholar
Asbed, G.and Hitov, S., “Preventing Forced Labor in Corporate Supply Chains: The Fair Food Program and Worker-Driven Social Responsibility,Preventing Forced Labor in Corporate Supply Chains: The Fair Food Program and Worker-Driven Social Responsibility, 52, no. 1 (2017): 497531.Google Scholar
Smith, V.K. et al., Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends, Kaiser Commission on Medicaid and the Uninsured (2011): at 50.Google Scholar
See Oberlander et al., supra note 58.Google Scholar
See Rahman and Gilman, supra note 16: at 183-186.Google Scholar
Office of the Healthcare Advocate, “2019 Annual Report,” available at <https://portal.ct.gov/-/media/OHA/OHA2019AnnualReport.pdf> (last visited August 23, 2020): at 21.!+(last+visited+August+23,+2020):+at+21.!>Google Scholar
Personal communication from Carrie L. Embree, Charles Quintana, and Niki Thompson to author (January 30 and February 20, 2020).Google Scholar
Barkow, R.E., “Insulating Agencies: Avoiding Capture Through Institutional Design,” Texas Law Review 89, no. 1 (2010): 1579; N. Bagley, “Agency Hygiene,” Texas Law Review 89, no. 1 (2010): 1–14; D. B. Schwarcz, “Preventing Capture Through Consumer Empowerment Programs: Some Evidence from Insurance Regulation,” University of Minnesota Law School, Legal Studies Research Paper Series Research Paper No. 12-06 (2012); D.G. Stein, “Perilous Proxies: Issues of Scale for Consumer Representation in Agency Proceedings,” NYU Annual Survey of American Law 67, no. 3 (2012): 513–587; B. Palmquist et al., “A Public Healthcare Advocate for Pennsylvania,” forthcoming report from Partners for Dignity & Rights and Put People First! Pennsylvania.Google Scholar
W.R. Ginsberg and F.M. Kaiser, “Federal Complaint-Handling, Ombudsman, and Advocacy Offices,” Congressional Research Service, Report # 7-5700 RL34606 (August 4, 2009).Google Scholar
See Bagley, id., at 2.Google Scholar
See Melish, supra note, 36, at 121-129.Google Scholar
See Cuellar, supra note 24, at 491-492.Google Scholar
Arkush, D. J., “Direct Republicanism in the Administrative Process,Direct Republicanism in the Administrative Process, 81, no. 5 (2013): 14581528.Google Scholar
Reports from each jury, available at <https://jefferson-center.org/projects/> (last visited July 9, 2020).+(last+visited+July+9,+2020).>Google Scholar
S. McKay, “A Jury of Peers: How Ireland Used a Citizens’ Assembly to Solve Some of Its Toughest Problems,” Foreign Policy, January 5, 2019, available at <https://foreignpolicy.com/2019/01/05/a-jury-of-peers/> (last visited August 23, 2020).+(last+visited+August+23,+2020).>Google Scholar
See also Krinks, R., Kendall, E., Whitty, J.A., and Scuffham, P.A., “Do Consumer Voices in Health care Citizens’ Juries Matter?Health Expectations: An International Journal of Public Participation in Health Care and Health Policy 19, no. 5 (2016): 10151022.CrossRefGoogle ScholarPubMed
See supra note 41 on critiques of deliberative democracy.Google Scholar
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