There is a strong desire in Europe to involve citizens in science and technology policy making where complex issues with wide relevance to society are concerned. One way of involving citizens is through ‘participatory technology assessment’ (PTA) exercises. The CIT-PART research project investigated the impact of PTAs on one controversial issue – ‘xenotransplantation’ (cross-species cell, tissue or organ transplants). CIT-PART found that while PTAs had little direct impact on policy in the cases studied, they could be considered a partial success because they had created and stimulated public debate.
CIT-PART compared the use and impact of PTA and expert-based technology assessment (TA) in science and technology policy in seven EU Member States (Austria, Denmark, Italy, Latvia, the Netherlands, Sweden and the United Kingdom), as well as in other countries and institutions (Canada, Switzerland, the European Commission, the OECD, and the Holy See (the Vatican)). The study involved wide-ranging analysis of literature and policy documents, and 135 in-depth interviews with policy makers, working at the national and international level, experts, stakeholders and representatives of NGOs involved in TA and PTA.
CIT-PART investigated the impact of participatory technology assessments on xenotransplantation policy in the late 1990s and early 2000s, given its ‘hot topic’ status at this time. Xenotransplantation was viewed as a potentially life-saving solution to the shortage of donor organs, and touched on fundamental issues including health risks, ethics, economics, genetic modification and animal welfare. The countries and organisations chosen for the study provided a wide range of cultural backgrounds, policies, and ways of dealing, in a relatively short time-scale, with an issue that might have a huge impact on citizens.
The project has come up with new ways of defining and measuring the impact of PTAs on complex issues. The ‘first generation’ of impact studies focused entirely on political decision-making, and impact was manifested solely by changes to policy decisions. A second generation of impact studies involved a wider range of actors, such as society and industry. CIT-PART draws attention to the need to rethink assumptions underlying these two approaches and developed a third understanding of impact that includes:
- The extent to which a participatory technology assessment enables diffusion to a wider audience previously unaware of the issue.
- How far a PTA performs a brokering role, connecting previously unconnected actor groups.
- Whether it enables new categories of interested citizens to emerge.
- If a PTA legitimises and validates the claims made by actor groups.
CIT-PART found that the public was rarely involved in xenotransplantation policy making in the countries and organisations studied. Civil servants and experts dominated policy development, and framed xenotransplantation primarily as a technical and scientific problem.
Countries using PTA on the issue of xenotransplantation
The public was only consulted using two-way communication methods by three governments – in Canada, Switzerland and the Netherlands. Methods used were citizen fora (Canada and Switzerland) and public discussions, for example following a play (the Netherlands).
CIT-PART could not establish direct unambiguous effects on policy in these cases, using a narrow definition of impact. In the Netherlands and Switzerland, the results of the PTA were only available after policies on xenotransplantation were adopted; in Canada, there was no official statement on xenotransplantation policies after the consultation, and no clinical trials were ever carried out.
The project did, however, uncover several important and valuable ‘softer’ impacts of PTA, and recommends its increased use in shaping complex policies. All three examples had an impact on the development of xenotransplantation regulation; contributed to public awareness of the issue and to the reconfiguration of relationships between relevant actor groups; and gave authority to claims made, and to actor positions in the debate and regulatory procedure.
Impact on policy in other countries and organisations
In other countries, public involvement was weaker - involving surveys, publishing reports online or information campaigns. Xenotransplantation was not a controversial issue in all countries, and the subject was framed in a diversity of ways - as an issue of organ shortage, risk, national economic competitiveness, trust in government, or competencies between parliament and government.
In Austria, the UK and the European Commission, participatory exercises were initiated by academics, but these had no direct impact on decision-making about xenotransplantation policies. The impact of expert-based technology assessment was varied. In the UK, expert TA had major impacts, for example recommendations in the Department of Health’s Kennedy Report became national policy which led to the setting up of the UK Xenotransplantation Interim Regulatory Authority (UKXIRA) and influenced the formation of EU xenotransplantation policy.
Industry and science contributed considerably as stakeholders in policy development, but ethicists played a lesser role and only became strongly involved in the UK, Canada and the Holy See. NGOs only became strongly involved in the UK, Canada, Switzerland and the Netherlands. Animal welfare organisations faced particular difficulties in participating in some countries, although in Austria, Denmark and Italy this was not an issue that raised controversy.
Policies adopted ranged from a ‘wait and see’ position, in which no policies were formulated (Austria) to permissive ones, which allowed clinical trials following approval by responsible authorities (the European Commission, the OECD, Italy, Latvia, Switzerland, the UK and the Holy See) to formal and informal moratoria on clinical trials (Canada, Denmark, the Netherlands and Sweden).
Factors facilitating the use of PTA in science and technology policy are:
- Traditions that exist on which PTA can build, for example commissions, adult education, direct democracy and consultation.
- Existing practices of openness and accountability.
- Using combinations of different methods such as surveys, emails, plays and conferences.
- Involvement of antagonistic groups in the PTA.
Factors constraining the use of PTA in science and technology policy are:
- Framing a topic as a scientific issue only, or as a matter of individual choice, excluding questions of risk, human rights, ethics, economics or politics.
- Case-by-case decision making on individual clinical trials.
- If the public do not consider themselves legitimate actors alongside experts and politicians.
- Traditions of paternalism, and strong and exclusive links between elites from science and civil service that exclude the public.
- Lack of infrastructure and funding.
CIT-PART’s primary recommendations are:
- The use of PTA should be increased and strengthened, particularly in expert advisory bodies at the international level, since these are pivotal for national policy making.
- Citizen involvement should be at the heart of framing the issue, and broad framing should be allowed for.
- Participatory technology assessment needs to be integrated into the organisational practices of formal policy bodies.
- PTA should be embedded in institutions to allow for learning.
- Existing participatory traditions should be built on.
- Lessons should be learnt from best practices of identifying and overcoming factors constraining PTA.
- Direct impact on policy making and public debate should be planned.
- Enough time should be allowed for PTAs, without regulatory bodies and governments yielding to industry and scientist pressure for rapid decisions.
CIT-PART- Impact of citizen participation on decision-making in a knowledge intensive policy (duration: 1/1/2009 – 30/6/2011). FP7 Socio-economic Sciences and Humanities, Activity 5, “The citizen in the European Union”, Research area 5.1 “Participation and citizenship in Europe”. Collaborative project (small and medium scale focused research project).
Contact: Erich Griessler, firstname.lastname@example.org