{"title":"对民主审议的无声挑战采取行动:六行动者框架。","authors":"Julian C. Jamison","doi":"10.1111/bioe.70180","DOIUrl":null,"url":null,"abstract":"<p>Political philosophers have long recognized that key stakeholders in policy decisions—children, future generations, nonhuman animals, and individuals with severe cognitive impairments—are structurally unable to participate in the deliberative processes meant to legitimate those decisions. This paper argues that such “voicelessness” is not a marginal complication to be accommodated at the edges of deliberative democracy (DD), but a first-order problem for exactly the large-scale, high-stakes domains—health, biotechnology, and environmental policy chief among them—where the voiceless often constitute the majority of those affected. This exclusion risks systematically neglecting crucial interests and suggests that some degree of surrogacy or representation by proxy is functionally unavoidable, whether or not DD's more demanding commitment to reasoned, preference-transforming deliberation is in play. Building on this recognition, and after critiquing the feasibility of idealized deliberative democracy as well as partial solutions implied by existing work, this paper's central contribution is a more pragmatic, ethically robust Six-Actor Framework. The framework delineates specific roles for policymakers, target populations, general laypeople, technical domain experts, and two novel categories: “benevolent partisans” (e.g., caregivers) and “agent-specific experts” tasked with interpreting or forecasting the interests of the voiceless. The utility of this structured approach is illustrated through three high-stakes policy domains: constructing global health metrics (DALYs) for cost-effectiveness analysis, animal welfare regulation, and the challenges involved when impacting the very existence of future people. This paper offers a path toward a policy process that is both practicable and ethically defensible, specifically for large-scale, high-priority global challenges.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"40 9","pages":"1000-1008"},"PeriodicalIF":2.3000,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.70180","citationCount":"0","resultStr":"{\"title\":\"Acting on the Voicelessness Challenge to Democratic Deliberation: A Six-Actor Framework\",\"authors\":\"Julian C. 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Building on this recognition, and after critiquing the feasibility of idealized deliberative democracy as well as partial solutions implied by existing work, this paper's central contribution is a more pragmatic, ethically robust Six-Actor Framework. The framework delineates specific roles for policymakers, target populations, general laypeople, technical domain experts, and two novel categories: “benevolent partisans” (e.g., caregivers) and “agent-specific experts” tasked with interpreting or forecasting the interests of the voiceless. The utility of this structured approach is illustrated through three high-stakes policy domains: constructing global health metrics (DALYs) for cost-effectiveness analysis, animal welfare regulation, and the challenges involved when impacting the very existence of future people. This paper offers a path toward a policy process that is both practicable and ethically defensible, specifically for large-scale, high-priority global challenges.</p>\",\"PeriodicalId\":55379,\"journal\":{\"name\":\"Bioethics\",\"volume\":\"40 9\",\"pages\":\"1000-1008\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2026-10-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.70180\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bioethics\",\"FirstCategoryId\":\"98\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/bioe.70180\",\"RegionNum\":2,\"RegionCategory\":\"哲学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2026/9/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ETHICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bioethics","FirstCategoryId":"98","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/bioe.70180","RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/9/9 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ETHICS","Score":null,"Total":0}
Acting on the Voicelessness Challenge to Democratic Deliberation: A Six-Actor Framework
Political philosophers have long recognized that key stakeholders in policy decisions—children, future generations, nonhuman animals, and individuals with severe cognitive impairments—are structurally unable to participate in the deliberative processes meant to legitimate those decisions. This paper argues that such “voicelessness” is not a marginal complication to be accommodated at the edges of deliberative democracy (DD), but a first-order problem for exactly the large-scale, high-stakes domains—health, biotechnology, and environmental policy chief among them—where the voiceless often constitute the majority of those affected. This exclusion risks systematically neglecting crucial interests and suggests that some degree of surrogacy or representation by proxy is functionally unavoidable, whether or not DD's more demanding commitment to reasoned, preference-transforming deliberation is in play. Building on this recognition, and after critiquing the feasibility of idealized deliberative democracy as well as partial solutions implied by existing work, this paper's central contribution is a more pragmatic, ethically robust Six-Actor Framework. The framework delineates specific roles for policymakers, target populations, general laypeople, technical domain experts, and two novel categories: “benevolent partisans” (e.g., caregivers) and “agent-specific experts” tasked with interpreting or forecasting the interests of the voiceless. The utility of this structured approach is illustrated through three high-stakes policy domains: constructing global health metrics (DALYs) for cost-effectiveness analysis, animal welfare regulation, and the challenges involved when impacting the very existence of future people. This paper offers a path toward a policy process that is both practicable and ethically defensible, specifically for large-scale, high-priority global challenges.
期刊介绍:
As medical technology continues to develop, the subject of bioethics has an ever increasing practical relevance for all those working in philosophy, medicine, law, sociology, public policy, education and related fields.
Bioethics provides a forum for well-argued articles on the ethical questions raised by current issues such as: international collaborative clinical research in developing countries; public health; infectious disease; AIDS; managed care; genomics and stem cell research. These questions are considered in relation to concrete ethical, legal and policy problems, or in terms of the fundamental concepts, principles and theories used in discussions of such problems.
Bioethics also features regular Background Briefings on important current debates in the field. These feature articles provide excellent material for bioethics scholars, teachers and students alike.