Maintaining the Divide: The Legitimate Role for the Public in Health and Science Policymaking

Abstract

Many of the most pressing policy choices we face are matters of health and science. How should we prepare for the next global pandemic? How should we manage the disruption and promise of artificial intelligence? How should we address the challenge of climate change? These choices are permeated by intractable disagreement, especially disagreement over the moral and prudential values we rely on to decide. Nonetheless, we must decide. Proceduralism is one of the most widely endorsed answers to the challenge that such normative disagreement presents. The policy choices we face, however, also include descriptive questions. Given the significant difference between these types of questions, the respective roles they ought to play in our collective decision-making, and the fact that their respective answers ought to be measured against different standards of justification and legitimacy, I argue that proceduralism fails as a complete account of legitimate decision-making and offer a more nuanced and epistemically informed account of legitimate decision-making. I conclude by assessing the implications the alternative account has for the role that the public should play in legitimate health and science policy-making, arguing that the public ought to play a central role in making normative decisions, but should be largely excluded from a participatory role in inquiries meant to decide matters of policy-relevant descriptive fact.