Democratisation of scientific advice
http://www.100md.com
《英国医生杂志》
1 Department of Health Policy and Management, Erasmus University Medical Centre, PO Box 1738, 3000 DR Rotterdam, Netherlands, 2 Faculty of Arts and Culture, University of Maastricht, PO Box 616, 6200 MD Maastricht, Netherlands
Correspondence to: R Bal r.bal@bmg.eur.nl
Dutch experience shows how scientific advisory bodies can cope with the growing political demands for transparency and lay participation without compromising their function
Introduction
The Health Council of the Netherlands reports on the state of knowledge concerning health to the Dutch government and covers a broad area of health, food, and environmental policy. The council consists of around 200 members but works on the basis of ad hoc committees that may also include non-member experts. It is one of the most influential science advisory committees in the Netherlands.8 This article draws on material from a qualitative study on the societal impact of the council's advisory work in which we followed the history of 10 council reports.9 These case studies included an analysis of all relevant documentation archived at the council and elsewhere. We carried out about 80 interviews, which were transcribed and coded. Preliminary conclusions from the case studies were validated in nine focus group sessions.
Providing transparency
To incorporate the views of the public in its committee process, the council transcends the distinction between scientific expertise and lay ignorance. Three types of expertise are identified, qualified, and thus legitimised—contributory, experiential, and consequential expertise (these are our terms).
Contributory expertise is substantive, scientific expertise about the issue being considered.14 This type of expertise is typically attributed to scientists that are selected for committee membership. Such experts are mostly professors at Dutch universities but may also be industrial researchers with an established name in the scientific community. Sometimes this expertise is obtained by interviewing these experts.
Experiential expertise is grounded in personal experience, such as having a specific disease. The council attributes this expertise to patients. In the words of former council president Jan Sixma: "If you ask a group of doctors to hear patients, they often don't want that, because `they know it all.' But that is just not true. They often don't know." Experiential expertise is mainly obtained through hearings with representative groups. In exceptional cases, a member from a patient organisation may be invited to join a committee. Potential patient members first have an interview with the council's president to validate their experiential expertise and to explain their role in the committee.
Consequential expertise is also typically obtained through oral consultation (and in special cases written consultation) with representatives of organisations that would be affected by the advice—for example, the health inspectorate and industry or patient associations. The main purpose of these consultations is to explore the knowledge about potential consequences that is not available in the literature but is crucial to producing meaningful advice. These consultations are carefully staged; discussion between the committee and invitees is avoided, and invitees are carefully selected to present the required type of expertise. Invitees usually describe their organisation's position on an issue, and the information enables the committee to tailor its advice to its target audience and to refine its advice in the light of problems encountered in practice.
Conclusion
Weingart P. Scientific expertise and political accountability: paradoxes of science in politics. Sci Public Policy 1999;26: 151-61.
Jasanoff S. Harmonization: the politics of reasoning together. In: Bal R, Halffman W, eds. The politics of chemical risk. Dordrecht: Kluwer Academic, 1998: 173-94.
Woodhouse EJ, Nieusma DA. Democratic expertise: integrating knowledge, power, and participation. In: Hisschem?ller M, Hoppe R, Dunn WN, Ravetz JR, eds. Knowledge, power, and participation in environmental policy analysis. New Brunswick: Transaction Publishers, 2001: 73-95.
Trusnet Framework. A new perspective on risk governance. Brussels: European Commission, 2000. (Report No EUR 19150 EN.)
Gulick L. Notes on the theory of organization. In: Gulick L, Urwick L, eds. Papers on the science of administration. New York: Institute of Public Administration, 1937: 3-13.
Fiorino DJ. Citizen participation and environmental risk: a survey of institutional mechanisms. Sci Technol Hum Values 1990;15: 226-43.
House of Lords Select Committee on Science and Technology. Science and society. London: Stationery Office, 2000.
Fortuyn WSP. Ordening door ontvlechting. Een advies over de adviesstructuur in de volksgezondheid. Rijswijk: Ministerie van WVC, 1990.
Bal R, Bijker WE, Hendriks R. Paradox van wetenschappelijk gezag. Over de maatschappelijke invloed van adviezen van de Gezondheidsraad, 1985-2001. The Hague: Gezondheidsraad, 2002.
Goffman E. The presentation of self in everyday life. 8th ed. London: Penguin, 1990.
Hilgartner S. Science on stage: expert advice as public drama. Stanford, CA: Stanford University Press, 2000.
Hindmarsh J, Pilnick A. The tacit order of teamwork: collaboration and embodied conduct in anesthesia. Sociol Q 2002;43: 139-64.
Gezondheidsraad. Dyslexie. Afbakening en behandeling. The Hague: Gezondheidsraad, 1995. (Report No 1995/15.)
Collins HM, Evans R. The third wave of science studies: studies of expertise and experience. Soc Stud Sci 2002;32: 235-96.(Roland Bal, assistant pro)
Correspondence to: R Bal r.bal@bmg.eur.nl
Dutch experience shows how scientific advisory bodies can cope with the growing political demands for transparency and lay participation without compromising their function
Introduction
The Health Council of the Netherlands reports on the state of knowledge concerning health to the Dutch government and covers a broad area of health, food, and environmental policy. The council consists of around 200 members but works on the basis of ad hoc committees that may also include non-member experts. It is one of the most influential science advisory committees in the Netherlands.8 This article draws on material from a qualitative study on the societal impact of the council's advisory work in which we followed the history of 10 council reports.9 These case studies included an analysis of all relevant documentation archived at the council and elsewhere. We carried out about 80 interviews, which were transcribed and coded. Preliminary conclusions from the case studies were validated in nine focus group sessions.
Providing transparency
To incorporate the views of the public in its committee process, the council transcends the distinction between scientific expertise and lay ignorance. Three types of expertise are identified, qualified, and thus legitimised—contributory, experiential, and consequential expertise (these are our terms).
Contributory expertise is substantive, scientific expertise about the issue being considered.14 This type of expertise is typically attributed to scientists that are selected for committee membership. Such experts are mostly professors at Dutch universities but may also be industrial researchers with an established name in the scientific community. Sometimes this expertise is obtained by interviewing these experts.
Experiential expertise is grounded in personal experience, such as having a specific disease. The council attributes this expertise to patients. In the words of former council president Jan Sixma: "If you ask a group of doctors to hear patients, they often don't want that, because `they know it all.' But that is just not true. They often don't know." Experiential expertise is mainly obtained through hearings with representative groups. In exceptional cases, a member from a patient organisation may be invited to join a committee. Potential patient members first have an interview with the council's president to validate their experiential expertise and to explain their role in the committee.
Consequential expertise is also typically obtained through oral consultation (and in special cases written consultation) with representatives of organisations that would be affected by the advice—for example, the health inspectorate and industry or patient associations. The main purpose of these consultations is to explore the knowledge about potential consequences that is not available in the literature but is crucial to producing meaningful advice. These consultations are carefully staged; discussion between the committee and invitees is avoided, and invitees are carefully selected to present the required type of expertise. Invitees usually describe their organisation's position on an issue, and the information enables the committee to tailor its advice to its target audience and to refine its advice in the light of problems encountered in practice.
Conclusion
Weingart P. Scientific expertise and political accountability: paradoxes of science in politics. Sci Public Policy 1999;26: 151-61.
Jasanoff S. Harmonization: the politics of reasoning together. In: Bal R, Halffman W, eds. The politics of chemical risk. Dordrecht: Kluwer Academic, 1998: 173-94.
Woodhouse EJ, Nieusma DA. Democratic expertise: integrating knowledge, power, and participation. In: Hisschem?ller M, Hoppe R, Dunn WN, Ravetz JR, eds. Knowledge, power, and participation in environmental policy analysis. New Brunswick: Transaction Publishers, 2001: 73-95.
Trusnet Framework. A new perspective on risk governance. Brussels: European Commission, 2000. (Report No EUR 19150 EN.)
Gulick L. Notes on the theory of organization. In: Gulick L, Urwick L, eds. Papers on the science of administration. New York: Institute of Public Administration, 1937: 3-13.
Fiorino DJ. Citizen participation and environmental risk: a survey of institutional mechanisms. Sci Technol Hum Values 1990;15: 226-43.
House of Lords Select Committee on Science and Technology. Science and society. London: Stationery Office, 2000.
Fortuyn WSP. Ordening door ontvlechting. Een advies over de adviesstructuur in de volksgezondheid. Rijswijk: Ministerie van WVC, 1990.
Bal R, Bijker WE, Hendriks R. Paradox van wetenschappelijk gezag. Over de maatschappelijke invloed van adviezen van de Gezondheidsraad, 1985-2001. The Hague: Gezondheidsraad, 2002.
Goffman E. The presentation of self in everyday life. 8th ed. London: Penguin, 1990.
Hilgartner S. Science on stage: expert advice as public drama. Stanford, CA: Stanford University Press, 2000.
Hindmarsh J, Pilnick A. The tacit order of teamwork: collaboration and embodied conduct in anesthesia. Sociol Q 2002;43: 139-64.
Gezondheidsraad. Dyslexie. Afbakening en behandeling. The Hague: Gezondheidsraad, 1995. (Report No 1995/15.)
Collins HM, Evans R. The third wave of science studies: studies of expertise and experience. Soc Stud Sci 2002;32: 235-96.(Roland Bal, assistant pro)