#  Meaningful Citizen Participation in Health Priority-Setting 

 





April 18, 2022

 

 

Professor Alicia Yamin recently spoke about her work on fostering meaningful citizen participation in health priority setting during a recent seminar co-sponsored by the Center for Health Decision Science and the Global Health Education and Learning Incubator. [Professor Yamin](/people/alicia-ely-yamin), a Senior Scholar in Residence at GHELI, is also a lecturer on Law and Senior Fellow on Global Health and Rights at the [Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School](https://petrieflom.law.harvard.edu/).

During the session, Professor Yamin noted the importance of promoting legitimate decisions, a broadly held view of health priority research, based on reasonable values and transparent and inclusive decision-making processes. Daniels and Sabin’s influential framework [Accountability for Reasonableness](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119050/pdf/1300.pdf) (A4R) captures the critical elements of procedural fairness, though it does not specify the conditions for its implementation.

Yamin indicated that trust and legitimacy are essential both in pandemic settings and normal times. A key concern is the need to address the stratification of power. This can be accomplished by equalizing background knowledge across participants, shared Yamin, involving interlocuters to balance power asymmetries, enabling participation by groups across the political spectrum and allowing them to designate their own representatives. Additionally, the stratification of power requires disclosure of conflicts of interest, guarantees of non-retaliation, techniques and frameworks that challenge internalized domination, and incorporates approaches for developing and implementing additional information in priority setting.

She ended the seminar with several open questions about the relationship between legitimacy and trust, as well as the role of policymakers play in pursuing strategies to manage power inequities while also addressing the structural sources.



 

 

 



 

 

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