Troutville: Where People Discuss Fairness Issues

Context . Public engagement efforts in health policy have posed manyvalue-laden questions, yet those that appreciate the complexity and diversity of the conceptof health equity are rare. We introduce the Fairness Dialogues, a new method fordeliberating health equity among the general public. We provide its theoretical underpinningand present its empirical illustration and qualitative assessment. Methods .Primarily informed by the scholarship of deliberation, we designed the Fairness Dialogues,featured by reason-giving and inclusive group deliberation using a hypothetical scenario(the town of Troutville) that presents carefully designed, simple, open-ended cases focusingon a chosen equity and fairness issue. To assess whether the Fairness Dialogues encouragesreflective views, we conducted a qualitative investigation by focusing on fairness andunfairness of inequalities in life expectancy. Findings . Our results revealed thecomplex intuitions that people have and their curiosity, patience, and willingness toscrutinize them in-depth through a small group dialogue. Intuitions shared by our studyparticipants are similar to those presented in the scholarly philosophical literature.Conclusions . The Fairness Dialogues is a promising method to incorporate thepublic’s views into policy-making involving value judgment and to develop the capacity ofthe public to discuss value-laden questions in a reflective and inclusivemanner.