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Soc Sci Med. 2012 Jun;74(12):1843-50. doi: 10.1016/j.socscimed.2012.02.023. Epub 2012 Mar 20.

The unbearable lightness of citizens within public deliberation processes.

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  • 1Department of Health Administration, Faculty of Medicine, Public Health Research Institute of University of Montreal (IRSPUM), University of Montreal, P.O. Box 6128, Branch Centre-ville, Montreal, Quebec H3C 3J7, Canada.


There is a growing literature examining the involvement of citizens in health policymaking. While determining what form such involvement should take and who should participate is of particular interest to policymakers and researchers, the current ontological understanding of what a citizen is suffers from "lightness." This essay thus seeks to provide more depth by shedding light on the ways in which individuals define what "being" a citizen means for them and choose to embody or not such a role. Inspired by a four-year ethnographic study of a Canadian science/policy network in genetics, which integrated citizens into its operation, this paper provides four biographical sketches that portray the complexity and richness of what these individuals were "made of." We reflect on how they sought to make sense of their participation in the network by drawing on a repertoire of cultural, relational and cognitive resources and on their lived experience. Their capacity to "be" a participant and to be acknowledged as such by the others was shaped by their values and interests and by the contributions they sought to realise throughout their participation. Our discussion suggests that the quest for the "ordinary" citizen is misleading. Instead, acknowledging the sociological concreteness of citizenship and understanding how it may be embodied and exercised should be a key focus in public involvement theory and practice in health care.

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