The focus of this thesis is mainly to investigate the external political process from consensus conference and the correlation between consensus conference and political policy aimed at understanding the external effect of the conference. This thesis also studies the influence of public conference on both the administrative body and city council and the operations of public policy. A case study putting its emphasis on the public conference in installing a harbor cable car system bears a sense of unique significance in the very first consensus conference on municipal agenda in Taiwan. It is found that a consensus conference is perhaps more suitable for local administration to solve municipal issues than for the central government to solve national agenda. Thus, local government should step up its efforts to promote the valuable channel of citizen participation via public conference in an attempt to raise the consciousness of citizenship. The purpose of this article is also to get in-depth knowledge of the correlation between the consensus conference and public policy via comparison and analyses of social theories and publications and to interview dedicated personnel with both the administrative agency and city council for further discussions, which could, in the end, serve as a probable option to solve controversial issues once the deliberative democracy is chosen. The opinions collected via on-site interviews with dedicated administrative agencies (e.g. Bureau of Urban development & Bureau of Human Resources Development) and Kaohsiung city council have been used to analyze and verify the political clout of the consensus onference outside the regular decision-making process, which might become a valuable lesson learned for both the central and local authorities in the future.

Although pressure ulcer (PrU) development is now generally considered an indicator for quality of care, questions and concerns about situations in which they are unavoidable remain. Considering the importance of this issue and the lack of available research data, in 2010 the National Pressure Ulcer Advisory Panel (NPUAP) hosted a multidisciplinary conference to establish consensus on whether there are individuals in whom pressure ulcer development may be unavoidable and whether a difference exists between end-of-life skin changes and pressure ulcers. Thirty-four stakeholder organizations from various disciplines were identified and invited to send a voting representative. Of those, 24 accepted the invitation. Before the conference, existing literature was identified and shared via a webinar. A NPUAP task force developed standardized consensus questions for items with none or limited evidence and an interactive protocol was used to develop consensus among conference delegates and attendees. Consensus was established to be 80% agreement among conference delegates. Unanimous consensus was achieved for the following statements: most PrUs are avoidable; not all PrUs are avoidable; there are situations that render PrU development unavoidable, including hemodynamic instability that is worsened with physical movement and inability to maintain nutrition and hydration status and the presence of an advanced directive prohibiting artificial nutrition/hydration; pressure redistribution surfaces cannot replace turning and repositioning; and if enough pressure was removed from the external body the skin cannot always survive. Consensus was not obtained on the practicality or standard of turning patients every 2 hours nor on concerns surrounding the use of medical devices vis-à-vis their potential to cause skin damage. Research is needed to examine these issues, refine preventive practices in challenging situations, and identify the limits of prevention.

The concept of Public Participation comes from democratic theory. The core assumes that people are interested in public affairs and participate constructively. The consensus conference is developed to solve democratic problems. IT invites people without specialized knowledge to discuss controversial issues before they read related data. They set important problems in the domain and ask the experts in public. they debate controversial issues and make a decision. The youth consensus conference is the promise of President Chen in April. It provides youth the opportunity to participate social democracy. And we discuss the comment response adequately, conference satisfy, and conclusion reachable to make sure the difference between experts and participators. 61.1% participators thought comment response adequately is important and better. 55.6% participators thought that the conference satisfy is important and positive. The great conclusion is anticipated. 44.1% participator had different comment in conclusion reachable. Because about half people thought conclusion reachable was not easy to achieve. The experts had almost the same opinion in comment response and they believed the existence of sufficient comment reachable system. It makes everybody would say everything. A part of experts the topics influence consensus. The experts thought the conclusions was not possible adopt by the government. The point is the knowledge gained and the process of discussion.

優質化治理的追求不僅講求政府間的互動學習，亦講求學習標的的擴散。近年來政府引進公民參與理念，打破閉門造車的政策制定模式，隨著時間的發展，諸多機關開始辦理公民會議，本研究應用擴散理論分析公民會議在行政體系內部擴散的成因，並討論公民會議在台灣擴散的發展及限制。本研究針對十餘場公民會議，利用次級資料分析及深度訪談，從動機、資源、環境、效益四項因素分析過去各機關單位辦理公民會議的經驗，並探究自公民會議引進至今所遭遇之阻礙。研究結果顯示政府機關透過多種管道與社會團體、學界進行互動，取得公民會議的相關資訊，同時機關首長基於個人理念、內部業務需求、外在環境壓力等考量指示辦理公民會議，這些面向的交互作用促成台灣公民會議於行政體系內部的擴散。然而在公民會議發展歷程中，因公民會議執行過程的瑕疵、後續產出可觀察性低、政黨理念未能貫徹、體制及配套措施不足、人事更替頻繁、公民會議的工具性消失等因素阻礙公民會議的發展。本研究發現公民會議在行政體系內部的擴散乃是政策企業家的努力，其夾帶豐富的資訊資源與機關單位互動，或直接或間接地成就公民會議的發展。然而基礎體制建設的缺乏對公民會議的發展形成限制，因此未來應致力於審議民主體制建設以及強化人力資源發展。由於本研究為初探性嘗試，建議未來隨著實務發展強化擴散模型建構，並深化我國政策學習及擴散的學術累積。 / Good governance emphasizes not only the interactions between governments, but diffusion of objects among governments. Recently, the government has imported the concept of citizen participation and breaks the traditional way of policy making. As time goes by, the development of citizen participation has been more mature. Many agencies have started holding consensus conferences. The thesis applies diffusion theory to analyze the reasons why consensus conferences diffused within the government and discusses its development and restriction. The study focuses on more than ten consensus conferences and uses secondary data and in-depth interview to collect research data. The author analyzes the experience of individual agency according to their motivation, resource, environment, and benefit; and the author also examines the obstacles in the development of the consensus conferences. The findings reveal that the government interacts with social groups and academic community to get information about consensus conferences. At the same time, the chiefs of the executive branches give an instruction about holding the activities based on their preferences, internal requirements, and the pressure of external environment. The interaction of these aspects makes a contribution to the diffusion of the consensus conferences within the government. However, the flaws of implementation processes, lower observability, lack of relative measures and infrastructure, frequent personnel rotation, and the disappearance of the instrumentality constrain the expanding of the ideas and operations. This research also finds that the diffusion of ideas and operations is accomplished due to the efforts invested by policy entrepreneurs; they use abundant resources and information to interact with agencies directly or indirectly promoting the development of consensus conferences. However, incomplete infrastructure constrains the expansion of consensus conferences. Therefore, this study proposes that the government should enhance infrastructure and human resource development regarding deliberative democracy. As an exploratory study, this thesis suggests the public administration field should strengthen the diffusion model and accumulate studies of policy learning and diffusion in the future.

In Lübeck fand 2010 eine Bürgerkonferenz zum Thema Priorisierung im Gesundheitswesen statt. 20 Bürger unterschiedlichen Alters und mit heterogenen Bildungshintergründen informierten sich über das Thema Priorisierung im Gesundheitswesen, diskutierten ihre Überzeugungen und Erfahrungen und verfassten am Ende ein gemeinsames Votum. Priorisierung im Gesundheitswesen war bei den Bürgern definiert als ein Gedankenkonstrukt darüber, welche Werte und Kriterien in der medizinischen Versorgung als wirklich wichtig empfunden werden, und welche weniger wichtig erscheinen. Aus diesen Überlegungen können Rangfolgen medizinischer Interventionen und Therapien erarbeitet werden. Diese Konferenz betreffend beantwortet diese Arbeit die Forschungsfragen, ob Bürger in der Lage sind ein solch komplexes Thema wie Priorisierung im Gesundheitswesen sinnvoll und weiterführend zu diskutieren, zu welchen inhaltlichen Ergebnissen sie dabei kommen und welche Bedeutung diese Ergebnisse für die Gesamtdebatte haben können. Die Lübecker Bürger haben einen gelungenen Diskurs geführt, was in dieser Arbeit anhand von Kriterien des Diskursethikers Jürgen Habermas herausgearbeitet wird. Mit dieser Methode eine Bürgerkonferenz zu analysieren wurde dabei innerhalb dieser Arbeit ein neuer Weg beschritten. Außerdem wird bezüglich der inhaltlichen Diskussion gezeigt, welche wichtige Bedeutung der Bürgerdiskurs für die Gesamtdebatte hat. Die Bürger haben einzelne neue Aspekte angesprochen, aber vor allem zeigt sich in der Analyse, dass die Lübecker Bürger einen Schwerpunkt bei Werten und Kriterien setzen, die das einzelne Individuum betreffen. Der Vergleich der inhaltlichen Ergebnisse der Lübecker Bürgerkonferenz mit den inhaltlichen Ergebnissen einer kanadischen citizens jury zu diesem Themenkomplex zeigt viele Parallelen und gibt damit den Hinweis darauf, dass ein länderübergreifender gemeinsamer Bürgerwille besteht.

Un intérêt grandissant pour le rôle du citoyen dans la prise de décision concernant la vie publique se développe depuis les dernières années. Le développement et la mise en oeuvre de divers mécanismes de participation citoyenne, comme les conférences citoyennes, témoignent de cet intérêt. Nombre de ces expériences ont fait l'objet d'une évaluation, mais essentiellement au niveau de l'efficacité ou du succès de l'exercice. Peut-on les évaluer sur le plan de l’éthique? Quels sont les défis éthiques posés par les mécanismes de participation citoyenne? Ce mémoire évalue une expérience de conférence citoyenne portant sur les avancées de la biologie humaine à l’ère de la génomique mise sur pied par le Groupe de recherche en bioéthique (GREB) de l’Université de Montréal en 2005. À l’aide du concept de l’éthique de la discussion, telle que proposée par quatre auteurs québécois, une analyse qualitative est effectuée sur six documents rédigés dans le cadre de la conférence. Deux catégories de résultats sont discutées. D’abord, les divers éléments relatifs à la conférence citoyenne qui ont soulevé notre attention. Ensuite, les préoccupations des participants en lien avec la science, la société et la participation. Une meilleure compréhension des aspects éthiques auxquels on devrait accorder une attention particulière contribuera à l’amélioration du mécanisme de conférence citoyenne et à son utilisation à long terme. / In recent years, there has been a growing interest in the role of citizens in public decision-making. This interest is reflected in the development and implementation of various citizen participation mechanisms, such as citizen conferences (also known as consensus conferences). Many of these experiences have been evaluated, but mainly in terms of their effectiveness or success. What are the ethical challenges posed by citizen participation mechanisms? This study looks at a citizen conference on advances in human biology in the era of genomics, held by the Groupe de recherche en bioéthique (GREB) of the Université de Montréal in 2005. The concept of discourse ethics, as developed by four Quebec authors, is used to conduct a qualitative analysis of six documents from the conference. Two categories of results are discussed: noteworthy aspects of the citizen conference and participants’ concerns with regard to science, society and their participation. A better understanding of key ethical issues will help to improve citizen conferences and their long-term use.

Entre 2008 et 2011, les lois de bioéthique françaises ont été examinées pour la seconde fois. A cette occasion, plusieurs débats polémiques ont été rouverts au cours d’une large consultation associant des « experts », des représentants de la société civile organisée et - pour la première fois en la matière - des citoyens lambda. Cette procédure originale, les « états généraux de la bioéthique », est étudiée par l’intermédiaire de la discussion relative à la potentielle légalisation de la gestation pour autrui (GPA). La théorie habermassienne de l’espace public et de la délibération permet de questionner ce processus de mise en discussion, initié par les mobilisations sociales, pris en charge par les pouvoirs publics et conclu par la promulgation d’une loi. Le concept de légitimité est au cœur de cette recherche, qui interroge ses fondements et met en lumière ses ambigüités. Expertise des comités de sages, recours aux citoyens ordinaires, vote parlementaire, constituent autant d’étapes par lesquelles la décision est progressivement construite et légitimée. Dans le cas présent, le dispositif participatif joue un rôle déterminant, véhiculant des représentations particulières de la démocratie participative, de la formation de l’intérêt général et de la loi « à la française ». / Between 2008 and 2011, the French bioethics laws were examined for the second time. On that occasion, a lot of polemical debates were re-opened, during a broad consultation involving “experts”, representatives of civil society and, for the first time in this field, ordinary citizens. This original procedure, the “états généraux de la bioéthique”, is studied through the controversy over legalization of gestational surrogacy. The Habermasian public sphere and deliberative democracy theory is used to question the discussion process initiated by social mobilizations, managed by public authorities and finalized by the promulgation of a law. Legitimacy is at the core of this doctoral research, which is wondering about its foundations and highlighting its ambiguities. The decision is progressively built and legitimated through the consultation of committees, the participation of citizens and the vote of the Parliament. In this case, the “états généraux de la bioéthique” play a crucial role by conveying some specific perspectives about participatory democracy, general will definition and “French style” law.

Un intérêt grandissant pour le rôle du citoyen dans la prise de décision concernant la vie publique se développe depuis les dernières années. Le développement et la mise en oeuvre de divers mécanismes de participation citoyenne, comme les conférences citoyennes, témoignent de cet intérêt. Nombre de ces expériences ont fait l'objet d'une évaluation, mais essentiellement au niveau de l'efficacité ou du succès de l'exercice. Peut-on les évaluer sur le plan de l’éthique? Quels sont les défis éthiques posés par les mécanismes de participation citoyenne? Ce mémoire évalue une expérience de conférence citoyenne portant sur les avancées de la biologie humaine à l’ère de la génomique mise sur pied par le Groupe de recherche en bioéthique (GREB) de l’Université de Montréal en 2005. À l’aide du concept de l’éthique de la discussion, telle que proposée par quatre auteurs québécois, une analyse qualitative est effectuée sur six documents rédigés dans le cadre de la conférence. Deux catégories de résultats sont discutées. D’abord, les divers éléments relatifs à la conférence citoyenne qui ont soulevé notre attention. Ensuite, les préoccupations des participants en lien avec la science, la société et la participation. Une meilleure compréhension des aspects éthiques auxquels on devrait accorder une attention particulière contribuera à l’amélioration du mécanisme de conférence citoyenne et à son utilisation à long terme. / In recent years, there has been a growing interest in the role of citizens in public decision-making. This interest is reflected in the development and implementation of various citizen participation mechanisms, such as citizen conferences (also known as consensus conferences). Many of these experiences have been evaluated, but mainly in terms of their effectiveness or success. What are the ethical challenges posed by citizen participation mechanisms? This study looks at a citizen conference on advances in human biology in the era of genomics, held by the Groupe de recherche en bioéthique (GREB) of the Université de Montréal in 2005. The concept of discourse ethics, as developed by four Quebec authors, is used to conduct a qualitative analysis of six documents from the conference. Two categories of results are discussed: noteworthy aspects of the citizen conference and participants’ concerns with regard to science, society and their participation. A better understanding of key ethical issues will help to improve citizen conferences and their long-term use.

面對高度科技化、工業化及專業化的社會，風險溝通已是政府面對環境爭議時難以規避的課題。回顧台灣近年來各項環境政策所遭遇的激烈抗爭，顯現政府風險溝通的不足。近年來興起的審議式民主，強調在理性與互惠的前提下，讓公民針對議題發表不同意見，成為政府替代傳統風險溝通的另一選項。尤其對於亟需完善風險溝通的高科技議題-「核廢料處置」而言，審議式民主似乎為其帶來契機。本研究透過分析「核廢何從電視公民討論會」審議活動過程政府與民眾的風險溝通關係，以及會議參與者的深度訪談資料，探討審議式會議如何落實風險溝通理念，藉此瞭解並反思審議式民主在台灣的實踐及其能否成為有效的風險溝通機制。 研究發現，在理論層面，審議式民主與風險溝通理論有許多相通之處；而在實踐層面，審議式民主得以落實風險溝通四項核心要素：「雙向互動」、「資訊公開、即時及更新」、「轉譯為常民語言」及「利害關係人參與」；除此之外，與會者及相關人員亦受到審議機制正向的影響；但在此會議中民眾與政府間信任關係的改善程度有限。本研究建議政府未來進行風險溝通時，應健全溝通管道、有效連結「會議結論」與「政策制定」、整合資訊公開管道並縮短數位落差、及處理與核能政策連動問題，方能有助於低放射性廢棄物的風險溝通。 / Risk communication is an unavoidable task when the government faces a highly industrialized and professionalized society. In the past years, environmental policies the government proposed and the protests these policies triggered show the deficiency of the government on risk communication. Recently, the rising deliberative democracy that emphasizes citizen dialogue on the basis of equality, rationality and reciprocity, could become an alternative to traditional risk communication for the government. Especially for the high-tech issue--disposal of nuclear waste-- which is desperate for comprehensive risk communication, deliberative democracy seems to bring the window of opportunity. Through examining the case of “Where Would the Nuclear Waste Go?” TV forum, this study explores risk communication between the government and citizens, and discusses how deliberative forum realizes the idea of risk communication in practice and delivers risk knowledge. Furthermore, this study rethinks the practice of deliberative democracy in Taiwan and accesses whether it could be an effective risk communication mechanism. This study discovers that there is no contradiction between the practice of deliberative forum and the theory of risk communication. Deliberative democracy facilitates four core elements of risk communication: “two-way communication,” “information disclosure, in time and update,” “transfer into the language of ordinary people” and “the participation of stakeholders.” In addition, the participants and staffs were empowered positively by the deliberative mechanism. However, the improvement of trust between the government and citizens is very limited. This study suggests that when conducting risk communication for the low-level radioactive waste issue, the government should enhance risk communication channels, link the conclusions of citizen forums to policy making, integrate various information disclosure mechanisms, bridge the digital divide, and deal with the problem related to the nuclear energy policy.

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