Involving the public in rationing decisions. The experience of citizens juries.

There is growing interest in involving the public in decisions about rationing health care. But who are the public, why should they be involved and how might this be achieved? This paper reviews an innovative new technique for involving the public in healthcare decisions, called citizens' juries. Despite some limitations, the experience of a number of pilots suggest that given enough time and information, the public is willing and able to engage in debates about the allocation of finite resources for health care. As there are no right or wrong answers in health care choices, it is vital that the decision making process has legitimacy, and that the public has an opportunity to be involved.

Setting priorities: is there a role for citizens' juries?

Citizens' juries are an attempt to meaningfully involve members of the public in decisions which affect them in their own communities. The Institute for Public Policy Research and Cambridge and Huntingdon Health Authority have recently piloted the first jury in the United Kingdom. Sixteen jurors sat for four days, hearing evidence from a number of expert witnesses. The jurors were asked to consider how priorities for health care should be set, according to what criteria, and to what extent the public should be involved in this process. This pilot was also an attempt to assess the process itself, and our initial evaluation indicates that, given enough time and information, the public is willing and able to contribute to the debate about priority setting in health care.