Turning theory and empirical research into reflective practice

Abstract

This paper shows how cross-disciplinary, qualitative research, approached from within the critical realist paradigm, provides access to many novel insights when applied to citizens’ experiences of deliberative means of Australian health policy development. Deliberative means of policy development – collectively, known as deliberative mini-publics - form part of a growing international, participatory-turn in policy development; they are heralded as more democratic and meaningful forms of citizen engagement. Yet citizens’ experiences at such times, have received little attention; even less in Australia, where deliberative mini-publics are still fledgling means of policy development. To create a fuller understanding of what ‘really happens’ within citizens’ experiences at these times, this research has examined the relevant mechanisms and effects of the deeply intertwined and mutually influential behavioural [subjective] and systems/structural [objective] factors. This demonstrates a pattern running through the data which illuminates the various ways that power can manifest on individuals, their interactions, their social settings, and their broader social contexts. The ontological-depth of view thus provided, enables a nuanced and holistic understanding of the combined effects of power; with the significance of communicative asymmetries and health policy administrators’ decision-making processes most pronounced. These features have been traced into a conceptual model which has become an empirically grounded, theoretical framework conducive to critical reflection on the various, socially-situated, trajectories outlined. This includes the ethical and political dimensions associated with the intended and unintended consequences of health policy administrators’ decision-making and communicative action when they operationalise deliberative mini-publics. The critical edge to the realist position adopted for this research culminates in a critique on what these research findings imply for the theory and practice of deliberative mini-publics in health policy settings, and several propositions are put forward as to why health policy administrators ought to adopt an approach to these engagement techniques that intentionally enables participating citizens to more effectively exchange knowledge and express their deliberative capacities.