THE ROLE OF EMOTION IN ENABLING AND CONDITIONING PUBLIC DELIBERATION OUTCOMES: A SOCIOLOGICAL INVESTIGATION
| Author | ARIS KOMPOROZOS‐ATHANASIOU,MARK THOMPSON |
| Date | 01 December 2015 |
| DOI | http://doi.org/10.1111/padm.12188 |
| Published date | 01 December 2015 |
doi : 10. 1111/p adm .12188
THE ROLE OF EMOTION IN ENABLING AND
CONDITIONING PUBLIC DELIBERATION OUTCOMES: A
SOCIOLOGICAL INVESTIGATION
ARIS KOMPOROZOS-ATHANASIOU AND MARK THOMPSON
Citizen participation in deliberation activities within public health systems is increasingly seen as
essential in achieving more patient-centred, equitable and democratic care. However,recent studies
show that patients’ lived, affective experience of illness and care remains poorly understood within
deliberative fora. In response, this article argues that emotion is central in mediating deliberation,
and in conditioning deliberative outcomes. To understand how this occurs, we use a sociologically
informed notion of ‘biographical affect’ to address links between emotion and social and political
action. Benets of this approach for healthcare deliberation are illustrated through an in-depth case
study of a major citizen participation forum in the UK National Health Service. Our conclusions call
for alternative orientations to participation that involve committed engagement with participants’
affective experiences.
INTRODUCTION
This article examines the important yet under-researched role of emotions in mediating
public deliberation, with a particular focus on citizen participation in health systems. In
recent decades, there has been growing interest in deliberation as a tool for improving
democracy in the operation of public services. Deliberation can be dened as the ‘giv-
ing, weighing, acceptance or rejection of reasons’ (Parkinson 2004, p. 379), communicated
between people through discourse (Carpini et al. 2004). Citizen participation is a promi-
nent method of deliberation, at both individual (micro) and public (macro) levels.1Withi n
the healthcare context, micro-level deliberations position patients as ‘active citizens’ taking
responsibility for planning their own options and choices for treatment (Bovaird 2007, in
Eriksson 2012). Deliberations at the macro level, which constitute the primary focus of this
article, involve putting policy questions to groups of citizens ‘who are given information,
listen to arguments, debate the issues’ (Parkinson 2004, p. 377) and offer recommenda-
tions to public organizations that enact policy. Such groups of citizens can increasingly be
found in health policy (Eriksson 2012), wherein deliberation is said to ‘democratize’ health
systems and improve quality of health decisions (see Martin 2011; Parkinson 2004).
This proliferation of deliberative practices in health is manifested internationally in
a range of government initiatives such as ‘user fora’ in the UK, ‘consumer groups’ in
Canada, ‘participation committees’ in Italy, ‘community councils’ in Portugal and ‘health
territorial governments’ in Spain (for a recent review of the latter three, see Serapioni
and Matos 2014). Yet in spite of such overwhelming adoption of deliberation there have
been serious criticisms: several authors argue that an overly rationalistic framework for
deliberation tends to exclude and often de-legitimize certain participants and discourses
(Carr 2007; Barnes 2008). Furthermore, professionals participating in deliberations often
struggle to handle emotional input – for instance anger –expressed in meetings and dis-
cussions with patient representatives (Renedo et al. 2015), or question the authenticity and
representativeness of emotional views contributed in scientic debates (Martin 2012).
Aris Komporozos-Athansiou is in the Health and Social Care Research department at King’s College London, UK. Mark
Thompson is at Judge Business School, University of Cambridge, UK.
Public Administration Vol.93, No. 4, 2015 (1138–1151)
© 2015 John Wiley & Sons Ltd.
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