Health-care goods are goods with peculiar properties, and where they are scarce, societies face potentially explosive distributional conflicts. Animated public and academic debates on the necessity and possible justice of limit-setting in health care have taken place in the last decades and have recently taken a turn toward procedural rather than substantial criteria for justice. This article argues that the most influential account of procedural justice in health-care rationing, presented by Daniels and Sabin, is indeterminate where concrete properties of rationing (...) institutions are concerned. Such properties inscribe substantial norms into institutions. These norms can derive validity only from democratic majority decisions, which must be seen as an instance of pure procedural justice. We therefore have to move the discussion to a meta-level and ask how concrete properties of institutions are being chosen. I suggest four criteria for sufficiently democratic institutional design choice and conclude that as institutional properties are likely to have effects on the resulting distribution of health care, design choices should be empirically informed and taken both democratically and deliberately. (shrink)

In the eyes of its citizens, liberal democracy is connected to at least three promises—the promises of autonomy, equality and rationality. To what extent citizens can view these promises as being fulfilled will affect political trust and support for democracy. The rise of populism and trends towards technocratic government have rightly been interpreted as arising from a gap between normative aspirations and institutional and practical realities. Does this mean that we should adjust our ideals to reality, or that we should (...) strive to bring realities closer to the ideal? Self-proclaimed ‘realists’ argue that democratic ideals are unattainable and that we should therefore settle for a second-best alternative, such as a competitive oligarchy. Against this position, we point out that deliberative democracy offers an attractive ideal for successful representation that can inform democratic innovation. However, deliberative democracy also remains institutionally underdetermined and needs to develop better criteria that enable us to determine if, how and under what conditions the attempt to fulfil democracy’s promises succeeds in practice. In this paper, we suggest a criterion of deliberative responsiveness as a measure for representative democracy’s success in fulfilling promises of autonomy, equality and rationality. We go on to show in what respects these promises tend to be broken in contemporary representative democracies and discuss strategies for institutional reform that have potential to counteract these problems. (shrink)

Steffen Ganghof’s Beyond Presidentialism and Parliamentarism can improve existing typologies in comparative government and has great potential for discussions about democratic innovation and reform. So far, democratic innovations like deliberative mini-publics have remained mostly additive, leaving the underlying decision-making logics of representative political systems unchanged. Ganghof’s ideas can move debates about how deliberative democracy is to be institutionalized forward. Semi-parliamentary government constitutes an intriguing option to meet both demands for legislative flexibility and responsiveness to citizens’ concerns and demands for stability (...) and accountability. At the same time, I identify a limitation of the book in the fact that Ganghof’s normative theory of democracy remains thin. To appeal to citizens in constitutional reform processes, proposals for semi-parliamentary reform need to do more than reconcile conflicting visions of majority rule. They need to speak to democracy’s central promises of equal autonomy and rationality. (shrink)

Im alltagssprachlichen Gebrauch beziehen wir den Begriff der Gerechtigkeit sowohl auf Verteilungen von Gütern als auch auf die Verfahren, durch die eine entsprechende Verteilung zustande gekommen ist. Rawls’ Konzeption von Gerechtigkeit als Fairness (Rawls 1999) bezieht sich auf die Verteilung von Gütern und Rechten und ist somit eine Konzeption substantieller Gerechtigkeit. Zugleich ist die Begründung seiner Gerechtigkeitsprinzipien prozedural: durch die Konstruktion des Urzustandes, in dem Parteien hinter dem Schleier des Nichtwissens Prinzipien auswählen, wird die Auswahl ebendieser Prinzipien determiniert.

Die zunehmende Komplexität von Entscheidungsgegenständen und die Vielzahl von Entscheidungen, mit denen Regierungen und Verwaltungsapparate konfrontiert sind, stellen diese vor erhebliche Herausforderungen. Ob in der Hoffnung auf sachkundigere, glaubwürdige Politikstrategien oder aus Angst, an der Wahlurne für Fehlentscheidungen verantwortlich gemacht zu werden, haben Regierungen in den vergangenen Jahrzehnten zunehmend Entscheidungskompetenzen an spezialisierte, nicht-majoritäre Gremien delegiert, welche in der Regel mit Experten besetzt sind.

In this comment on Cristina Lafont’s new book Democracy without Shortcuts, I apply some of her ideas to the Brexit case in order to show that her identification of problematic shortcuts has significant analytical potential when it comes to understanding contemporary challenges to democracy. I argue that the push for Brexit can be viewed as a response to ‘expertocratic’ shortcuts in European Union decision-making, while David Cameron’s attempt to resolve the conflict once and for all by referendum constituted a ‘proceduralist’ (...) shortcut. I conclude by asking whether Lafont’s suggestion to ‘constitutionalize’ discourses and decisions could also imply seeking a meta-deliberative assessment of democratic institutions. (shrink)