Level of Justification

The next DQI measure to discuss is level of justification. This measure provides insight into the level of justification participants apply to their arguments. King argues that “justification emphasizes the requirement for reason to involve clear links between premise and

conclusion” (King, 2010, 3). Justifications can be sophisticated or average. It can be defined as sophisticated if it is linked to the topic a number of times and rational reasons provided. Justifications help participants of deliberation engage rationally in discourse and also has a role to play in the transformation of preference as good justifications could potentially persuade a participant to change their preference. Non-rational justifications might encourage participants to solidify their initial preferences.

In table 5.5, frequency data is displayed for the NICE vitamin D and NSP data for the level of justification provided. There are six levels of justifications. Coding was applied to speech

126

acts when; a) the speaker did not present any arguments, for example asks for additional information; b) when the speaker only says that X should or should not be done but no reason is given for why X should / should not be done; c) when the speaker justifies only with an illustration why X should / should not be done; and d) when the speaker gives a reason Y why X should / should not be done but no linkage is made why Y will contribute to X. Coding was applied to speech acts when; e) the speaker gives a reason Y why X should / should not be done, and a linkage is made why Y will contribute to X and, coding was applied when; f) the speaker gives at least two reasons why X should be done and for at least two reasons a linkage is made with X.

Table 5.5: NICE data - Level of justification (percentage and number)

NICE (Vitamin D)

NICE (NSP)

No argument presented (a) 13.7% (23) 6.4% (3)

No reason given (b) 20.8% (35) 27.7% (13)

Justified with an illustration (c) 4.8% (8) 12.8% (6) Reason given but no link made (d) 13.1% (22) 6.4% (3) Reason given and 1 link made (e) 39.3% (66) 44.7% (21) Reason given and at least 2 links made (f) 8.3% (14) 2.1% (1)

In table 5.5, the data shows that there was a high frequency of reasons being provided and a link being made to the topic in both samples (39.3% in Vitamin D and 44.7% in NSP). This means that committee members provided reasons for their positions and arguments and were able to link this to the topic under discussion so a rational link was applied. This could be described as a reasonable sophisticated level of justification.

In the comparison cases, an older version of the DQI was applied and therefore the codes are labelled differently. Given that the newest version of the DQI was used to code NICE

deliberation (see chapter four, section 4.2 for detail), the NICE data has been re-defined so the data could be properly compared using the older DQI coding. Codes (e) and (f) in table 5.5 have been added together in table 5.6 to define a sophisticated justification.

127

Table 5.6 displays the NICE data compared with the citizens in the Belgium and UK

parliament data to explore at what level do different groups justify their positions and if there are any similarities / differences between groups.

Table 5.6: NICE, citizens and UK parliamentarian data - Level of justification data (percentage) NICE (Vitamin D) NICE (NSP) Citizens (Belgium) Parliamentarians (UK)

No argument presented (a) 13.7% 6.4% n/a n/a

No reason given (b) 20.8% 27.7% 18.0% 12.9%

Inferior justification (c) 4.8% 12.8% 27.0% 29.0%

Qualified justification (d) 13.1% 6.4% 12.0% 12.9%

Sophisticated justification (e) 47.6% 46.8% 38.5% 45.2%

Total 100.0% 100.0% 100.0% 100.0%

In all cases, there was a higher frequency of sophisticated justification (e) being provided compared with any other level of justification. Committee members (47.6% in Vitamin D and 46.8% in NSP) and parliamentarians (45.2%) appear to apply sophisticated levels of

justifications for their arguments at similar frequencies. Citizens in the Belgium study

provided slightly less sophisticated justifications (38.5%) compared with committee members and parliamentarians.

The data suggests that experts, citizens and parliamentarians can all provide sophisticated justifications for their positions when deliberating together. In all the studies, the participants of deliberation were made up of the same type i.e. experts, citizens and parliamentarians and when deliberating together participants can provide sophisticated justifications. It is not clear what might happen if bringing all these participants together would change the frequency of sophisticated justifications being provided. It is interesting for NICE to note however that citizens can also provide sophisticated justifications for their arguments. It is not only experts who can provide well-reasoned and rational arguments. By involving more citizens, this could make the NICE process more inclusive.

128

Given that there is a high frequency of sophisticated justification in the NICE PHAC meetings, this suggests that high quality reasons and justifications are being provided by committee members and this is a characteristic of expert deliberation. This is because

arguments must be of a high quality, justified and reasoned. Having said that, while it is ideal that NICE committee members apply sophisticated levels of justification to their arguments, this might not actually mean that the deliberative environment is democratic. The process could still be quite exclusive in terms of other democratic standards such as participation and equality. When exploring the type of participant engaged in the NICE PHAC meetings, participation was mainly made up of experts and there was little input from other types of participants such as service users, carers or lay citizens. This makes the process quite exclusive despite a high deliberative quality.