Public deliberation in New Zealand hosted by Toi te Taiao: the Bioethics Council on the cultural, ethical, spiritual issues of pre-birth testing using face-to-face & online methods based on the Kettering Foundation's framing and National Issues Forums' workshop methodologies
Problems and Purpose
Pre-implantation Genetic Diagnosis (PGD), which was a new reproductive technology, was one of the major international bioethics issues of mid-2000s. Toi te Taiao: the Bioethics Council (the Council) decided to promote public dialogue about its cultural, ethical and spiritual issues as set out in its Terms of Reference. However, the topic was broadened to all pre-birth testing because:
- very few New Zealanders had any experience of PGD but most had for other pre-birth tests
- many of issues with PGD are similar to those for other pre-birth tests
- there had been limited public input into policy-making for the other pre-birth tests
- there were lots of inconsistences and issues with policy for other the tests due to its piecemeal development.
The Council also decided to use a process based on deliberative dialogue in an attempt to make more robust policy recommendations.
Background History and Context
This was the Council's third major national dialogue processes and built on its previous work. More information and context is available in the Participedia profile for the Council.
Organizing, Supporting, and Funding Entities
The process was organised by the Council's secretariat, which included 2 members who had completed the Dialogue, Deliberation and Public Engagement course jointly taught by Dr Lyn Carson at the University of Sydney and Dr Jan Elliott for the Fielding Graduate University.
The Council was supported by many individuals and organisations from the start to the finish of the project and beyond including the Nathaniel Bioethics Centre, the Interchurch Bioethics Council, Rural Women New Zealand, the National Council of Women, a Women's Refuge, a number of kindergartens and a kohanga reo, professional facilitators and independent evaluators, etc
The project was funding from the Council's operational budget.
Participant Recruitment and Selection
A range of strategies were used to recruit diverse participants including:
- kindergartens and a kohanga reo recruited diverse sample of their communities for workshops at their premises
- a range of stakeholder organisations advertised opportunities to participate using their own channels
- national and local news media reporting and advertising encouraged participation
- online advertising on trademe.co.nz, which had 60% of NZ's website traffic at the time
- participants in previous Council processes were contacted and encouraged to take part.
Methods and Tools Used
Stage 1: Issue identification
11 semi-structured interviews with diverse experts by Council members were analysed to create an issue booklet that informed participation in Stage 2.
Stage 2: Framing
Six 1-day framing workshops, including two for Māori, using the Kettering Foundation's Naming and Framing methodology informed the development of a face-to-face and online choicebooks that informed Stage 3.
Stage 3: Deliberation
Eighteen 3-hour deliberative workshops were held in locations all over New Zealand based on the National Issues Forum (NIF) methodology. In addition to these, three 20-person, 3-week, online deliberation groups used a modified NIF methodology on Ascentum's DialogueCircles platform.
A working group of Council and Secretariat members and a professional report writer did an argument and thematic analysis and developed Council responses and recommendations, which were presented in a formal report and in personalised participant reports for those who had taken part in the online process.
What Went On: Process, Interaction, and Participation
Independent evaluation reports are available on the Council's website.
Influence, Outcomes, and Effects
The process was widely supported as were the Council's recommendations, including by organisations that did not agree with all the recommednations but felt their perspectives had been well considered.
An election and change of government in 2008 meant that the recommendations were never formally responded to by the Government.
Many of the recommendations were about ways of improving the health system that did not require legislative change. Many of these improvements were implemented by officials.
The Council was disestablished in 2009.