Abstract

Democratic ideals are invoked frequently in debates on health and healthcare governance, yet the meaning and practical implications of “democracy” in this context often remain underspecified. This workshop builds on an ongoing scoping review that maps how the relationship between democracy and health is conceptualized across the bioethics, public health, and health policy literature. The review identifies the main normative justifications, institutional forms, and practical functions attributed to democratic approaches in healthcare governance, as well as recurring tensions, limitations, and gaps in the field.

The workshop has two aims. First, it will present the preliminary findings of the scoping review, offering participants an overview of how democratic healthcare governance is currently framed in the literature. Second, it will use these findings as a basis for a structured discussion aimed at refining a set of guiding questions and possible design principles for democratic healthcare governance. In particular, the workshop will invite participants to reflect on questions such as: What makes healthcare governance meaningfully democratic? Which forms of participation, representation, deliberation, and accountability are normatively desirable and practically feasible? How should democratic aspirations be balanced against expertise, efficiency/effectiveness, and equity?

Rather than treating democracy as a self-evident good, the workshop seeks to examine the conditions under which democratic arrangements in healthcare governance can enhance legitimacy, responsiveness, and fairness, and when they may instead produce tensions or unintended effects. By combining empirical mapping with normative discussion, the session is intended both to validate and to deepen the emerging framework developed in the review. The workshop will therefore generate feedback not only on the interpretation of the literature, but also on the broader conceptual and practical agenda for future work on democratic healthcare governance.

The discussion will be organized around a small set of thematic prompts derived from the review findings, with the goal of identifying areas of convergence, disagreement, and priority for further research. The session is designed for scholars working in bioethics, public health ethics, health policy, and related fields who are interested in the ethical and institutional foundations of democratic governance in health.