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Table of contents: A review of the Danish, Dutch and UK approaches to this special form of technology assessment
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1. Introduction

In recent years, the relationship between science and the public has become a subject of increasing concern and activity across much of the industrialized world. (Throughout this report, the word "science" is used to denote all of the natural, the life and the medical sciences and their associated technologies; and the word "public" is used to denote the members of the general community in their roles as citizens or "lay people" rather than as scientists or technical experts.) Throughout western Europe, efforts have been made to monitor levels of public interest in, understanding of and attitudes towards science; and at the same time, numerous practical initiatives have been launched with a view to promoting greater public awareness and understanding of science (Durant, 1994).

Recent events in the United Kingdom illustrate well the general trend. In 1983, the Royal Society of London set up an ad hoc group under the chairmanship of Dr (now, Sir) Walter Bodmer to investigate the public understanding of science. The publication of the Bodmer Report in 1985 led to: the creation of a major research programme on the public understanding of science funded by the Economic and Social Research Council (ESRC); the establishment of a standing Committee for the Public Understanding of Science (COPUS); and the launch of several new practical programmes such as science writing prizes, a media fellowship scheme and a small grant scheme for the support of efforts to popularize science in the community (Royal Society, 1985). In 1993, a UK government white paper on science made the promotion of public awareness of science a part of science policy for the first time (H M Government, 1993).

There are many more-or-less obvious reasons for the recent growth of concern and activity about the relationship between science and the general public. From the point of view of the scientific community, efforts to promote greater public understanding of science may be regarded as: first, a part of the educational investment that helps to secure continuing recruitment of suitably talented and trained young people into the scientific community; second, a part of the educational investment that helps to secure a suitably trained work-force that is capable of utilizing scientific innovation within industry; and third, a part of the public relations investment that helps to secure continuing public support for the process of scientific innovation.

From the point of view of the public, efforts to promote greater public understanding of science may be regarded as a response to the enormously influential role of science in modern industrialized societies. Culturally, science is a recognized source of authority and legitimation in industrial societies; practically, science has multiple influences on everyday life in industrialized societies; and politically, science is involved in many key issues of public policy in industrialized societies. For cultural, practical and political reasons, therefore, it has become increasingly widely accepted that the public should possess at least a minimal acquaintance with both the processes and the products of scientific inquiry. (For lengthier reviews of these issues, see Durant, 1990, 1993.)

There is one further and vitally important reason why the public understanding of science has come to assume particular importance in recent years. Throughout the last quarter of the twentieth century, scientific innovations have become increasingly socially sensitive. By this, we mean that in addition to purely technical and economic considerations scientific innovations have commonly raised wider moral, social, legal and political issues that have become the focus of considerable public interest, public concern and public debate. Obvious examples here include public controversies over the environmental and human health impacts of new industrial technologies such as civil nuclear power, and public anxieties about the ethical implications of new medical technologies such as in vitro fertilization, genetic diagnosis and organ transplantation.

Social sensitivity in the sense in which we have defined it means that continuing public support for the process of scientific innovation cannot be simply taken for granted; rather, it must be continually won through the creation and the preservation of a healthy relationship between science and the public. A great deal of the literature on public attitudes towards science suggests that the single most important ingredient in the maintenance of positive (i.e., generally supportive) attitudes is public confidence or trust in the institutions of science. For example, well-known cases in which sections of the public have appeared to differ from scientists over the relative risks associated with particular technologies have been interpreted as reflections of underlying public distrust of scientific institutions (see, for example, Turner and Wynne, 1992).

Where science is socially sensitive, the question arises: how should public interests and concerns be identified and incorporated into the processes of science policymaking? In the UK, for example, public planning inquiries and Royal Commissions have acted as forums before which a variety of experts and lay people have been able to present conflicting arguments and evidence concerning particular socially sensitive scientific developments. In addition, governmental regulatory agencies have sometimes called for public inputs to the policy-making process. For example, the UK Human Fertilization and Embryology Authority (HFEA) recently invited public responses to a document setting out some of the ethical issues involved in new methods of assisted reproduction such as the use of ova from human foetuses and cadavers for purposes of in vitro fertilization (HFEA, 1993).

In this report, we consider a rather different and relatively new method by which public interests and concerns may be identified and incorporated into the processes of science policy-making: the "consensus conference". A consensus conference is a forum in which lay people develop and put forward their views on socially sensitive scientific questions through dialogue with experts. Although the term consensus conference has its origins in the USA, where it was first used in connection with organized dialogues between panels of medical experts (Jacobs, 1993), it was taken up by the Danish Board of Technology (DBT) in the 1980s to describe a new form of technology assessment involving a panel of lay people chosen on the basis of national advertisements. Over the past 8 years the DBT has organized a series of consensus conferences on subjects such as food irradiation (1989) and technological animals (1992). In 1993, the Dutch followed the Danish initiative by organizing a consensus conference on the subject of genetic modification of animals; and also in 1993, the UK Agricultural and Food Research Council announced that it was to fund the Science Museum, London, to organize a first UK national consensus conference on plant biotechnology.

The Danes have clearly come to regard the consensus conference as a valuable contribution to public policy-making in socially sensitive areas of science. The Dutch are still considering their experience with a first consensus conference in 1993; and in the UK, the first national consensus conference which will take place later this year will be thoroughly evaluated in order to determine the potential value of this novel procedure in other areas of science policy.

In this report, we summarize and draw lessons from the European experience to date with Danish-style consensus conferences. The report comprises four main sections. First, we define and characterize the consensus conference. Second, we assess consensus conferences as a form of technology assessment in the light of the Danish, the Dutch and the UK experience. Third, we describe in more detail the organization of a consensus conference, with particular reference to the current planning of the UK consensus conference on plant biotechnology, in which we are both personally involved. Fourth, we make recommendations regarding the proposed Swiss national consensus conference on biotechnology.