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Lookup NU author(s): Daniel Hutton FerrisORCiD, Dr Johannes KniessORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
This article assesses the normative case for using citizens' assemblies—small deliberative forums of randomly selected citizens—in health policymaking. Although they are increasingly popular, their normative justification remains underexplored. We reconstruct three possible rationales: Norman Daniels's ‘Accountability for Reasonableness’ (A4R) framework; an epistemic argument emphasising the value of outsider perspectives for making more just decisions; and a deliberative democratic argument focused on promoting legitimacy in the bureaucracy. We argue that A4R offers only weak and contingent support for citizens' assemblies. The epistemic argument highlights the value of lay perspectives in identifying epistemic blind spots but lacks clarity on when it outperforms expert knowledge. The deliberative democratic rationale is more compelling in potentially generating some kinds of legitimacy but applies only in a limited range of scenarios. We therefore conclude that the normative case for using citizens' assemblies is not as strong as their popularity in policymaking would lead us to believe.
Author(s): Hutton Ferris D, Kniess Johannes
Publication type: Article
Publication status: Published
Journal: bioethics
Year: 2026
Issue: ePub ahead of Print
Online publication date: 21/04/2026
Acceptance date: 03/04/2026
Date deposited: 23/04/2026
ISSN (print): 0269-9702
ISSN (electronic): 1467-8519
Publisher: Wiley-Blackwell Publishing Ltd.
URL: https://doi.org/10.1111/bioe.70111
DOI: 10.1111/bioe.70111
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