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Making policy decisions about population screening for breast cancer: The role of citizens' deliberation

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  • Paul, Charlotte
  • Nicholls, Rachel
  • Priest, Patricia
  • McGee, Rob

Abstract

Objective To test a method of assessing whether a community of interest - when well informed - would be prepared to support or reject a public policy decision about cancer screening. In particular, whether the New Zealand government should offer free mammography screening to all women aged 40-49 years.Methods Eleven women aged from 40 to 49 years, randomly selected from the electoral roll, agreed to participate in trial of a citizens' jury: a deliberative method of gathering the views of the public. Only selected aspects of the jury method were trialled. Participants met over a day and a half to hear evidence from expert witnesses with differing views and to deliberate the verdict.Results All but one woman changed their minds during the jury process, and voted against government provision of mammography screening in this age group. The main reasons reported were the inaccuracy of the test and the potential for harm, and the lack of firm evidence of saving lives in this age group.Conclusions A deliberative 'citizens' jury' approach is a feasible way of eliciting a well informed, considered community view about screening or other population health initiatives. Pro-screening views of affected populations may change when individuals are given accurate information and enabled to deliberate about benefits and harms. This method could be used to determine how complex benefits and harms are weighed by affected populations, particularly where experts and advocacy groups disagree.

Suggested Citation

  • Paul, Charlotte & Nicholls, Rachel & Priest, Patricia & McGee, Rob, 2008. "Making policy decisions about population screening for breast cancer: The role of citizens' deliberation," Health Policy, Elsevier, vol. 85(3), pages 314-320, March.
    • Handle: RePEc:eee:hepoli:v:85:y:2008:i:3:p:314-320
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    References listed on IDEAS

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    1. Lenaghan, Jo, 1999. "Involving the public in rationing decisions. The experience of citizens juries," Health Policy, Elsevier, vol. 49(1-2), pages 45-61, September.
    2. Aldred, Jonathan & Jacobs, Michael, 2000. "Citizens and wetlands: evaluating the Ely citizens' jury," Ecological Economics, Elsevier, vol. 34(2), pages 217-232, August.
    3. Graham Smith & Corinne Wales, 2000. "Citizens' Juries and Deliberative Democracy," Political Studies, Political Studies Association, vol. 48(1), pages 51-65, March.
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    1. Carman, Kristin L. & Mallery, Coretta & Maurer, Maureen & Wang, Grace & Garfinkel, Steve & Yang, Manshu & Gilmore, Dierdre & Windham, Amy & Ginsburg, Marjorie & Sofaer, Shoshanna & Gold, Marthe & Path, 2015. "Effectiveness of public deliberation methods for gathering input on issues in healthcare: Results from a randomized trial," Social Science & Medicine, Elsevier, vol. 133(C), pages 11-20.
    2. Parker, Lisa, 2017. "Including values in evidence-based policy making for breast screening: An empirically grounded tool to assist expert decision makers," Health Policy, Elsevier, vol. 121(7), pages 793-799.
    3. De Vries, Raymond & Stanczyk, Aimee & Wall, Ian F. & Uhlmann, Rebecca & Damschroder, Laura J. & Kim, Scott Y., 2010. "Assessing the quality of democratic deliberation: A case study of public deliberation on the ethics of surrogate consent for research," Social Science & Medicine, Elsevier, vol. 70(12), pages 1896-1903, June.
    4. Abelson, Julia & Tripp, Laura & Sussman, Jonathan, 2018. "‘I just want to be able to make a choice’: Results from citizen deliberations about mammography screening in Ontario, Canada," Health Policy, Elsevier, vol. 122(12), pages 1364-1371.
    5. Street, Jackie & Duszynski, Katherine & Krawczyk, Stephanie & Braunack-Mayer, Annette, 2014. "The use of citizens' juries in health policy decision-making: A systematic review," Social Science & Medicine, Elsevier, vol. 109(C), pages 1-9.
    6. Harri Raisio & Pirkko Vartiainen, 2015. "Accelerating the public’s learning curve on wicked policy issues: results from deliberative forums on euthanasia," Policy Sciences, Springer;Society of Policy Sciences, vol. 48(3), pages 339-361, September.

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