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Stakeholder Dialogue as Deliberation for Decision Making in Health Policy and Systems: The Approach from Argumentation Theory

Rubinelli, Sara PhD; von Groote, Per Maximilian MA

American Journal of Physical Medicine & Rehabilitation: February 2017 - Volume 96 - Issue 2 - p S17–S22
doi: 10.1097/PHM.0000000000000635
Research Articles

Objective: The literature on knowledge translation and dissemination in health care highlights the value of the stakeholder dialogue, namely, a structured process where stakeholders interact to identify the best solution to a given problem. By analyzing the stakeholder dialogue as a form of deliberative argumentation, this article identifies those factors that may hinder or facilitate reaching agreement among stakeholders on options to target problems.

Design: Conceptual analysis based on the descriptive and evaluation methods of argumentation theory.

Results: When stakeholders have a difference of opinion, confrontation alone does not lead to agreement. A normative model of critical discussion is needed to facilitate stakeholders in reaching this agreement and to prevent barriers to it that can result from personal factors (e.g., attitude and beliefs) or communication moves. This type of dialogue requires a training of stakeholders about the preconditions of argumentation and its different stages. The figure of the moderator is crucial in ensuring that the dialogue fulfills standards of reasonableness.

Conclusion: This article offers a reading of the stakeholder dialogue rooted in the tradition of critical thinking. It instructs on how to promote a collaborative exchange among stakeholders as a way to go beyond any expression of views.

From the Department of Health Sciences and Health Policy, University of Lucerne and Swiss Paraplegic Research, Lucerne; and Swiss Paraplegic Research, Nottwil, Switzerland.

All correspondence and requests for reprints should be addressed to: Sara Rubinelli, PhD, Swiss Paraplegic Research, Guido Zäch Institute, Guido Zäch-Strasse 4, CH-6207 Nottwil, Switzerland.

The funding for this study was provided by Swiss Paraplegic Research.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.