Starting the search for common ground
Simon
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I want to try and give you a sense of how a group might start its search for common ground, even though we have not fully prepared ourselves for this process - no one has explored all the approaches but please review the choicebook and discussions in the other threads to try and get a sense of the issues and what's at stake for supporters of all the approaches.
Once you have reviewed all the approaches, the next step is to think about and identify 3-5 policy proposals/actions that you think most people could live with. These might come from one approach but will more likely be a combination of actions drawn from all the approaches. It's also possible that you might think of a policy action that is not associated with any of the approaches. (I wouldn't normally limit it to a max of 5 actions but I don't want you to do too much work).
Once you have identified your actions, post them to this thread. Late tomorrow, I will collate all your proposed actions.
We'll likely see that a lot of you will proposal some similar actions and that there will also be a few actions that have been proposed by only one or a few people. While this gives us a sense of how much support there is for proposals, it would not be the final word. The collated list would form the agenda for the next set of discussions aimed at being able to put forward the group's advice - but we're not going to attempt this in this simulation.
This is the one task that I want you to do as individuals and I don't want you to do any more work that just post your actions. There's no need to enter into any further discussion in your group as you've done enough work.
Finally, here's a facilitator's rule of thumb for knowing when people are ready to search for common ground. A group is ready when everyone can make a good case for the approach they support least and also point out the problems and weaknesses of the approach they most favour.
Pi Say Fri 22 Nov 2019 9:17AM
First of all, before designing policy options, I would suggest that understand people’s different perspectives/their concerns about pre-birth testing which I agree with @John Penny. Therefore it is important for the government to answer with those concerns and explain the importance of this program. So it can creates the mutual understanding between the government and citizens on pre-birth testing. To achieve this mutual understanding, I agree with other members' ideas @Margaret Aulda @Izzy @John Penny that evidence-based interventions, data, and consultations are being used to support decision making and design program.
However, some proposed policy options can be
a. Online: the government should make relevant information available online. so people can have access about program. Furthermore, if it is possible, people can also check their health/family history to see the possibility of having unhealthy-child.
b. Hospital-based services: this is just like the other members' inputs about pre-birth testing in the early stage of pregnancy which services are provided in hospitals.
c. Community field visit: this program aims to make services more accessible and convenient. GPs organize the pre-birth testing in the communities on the weekend which women have time to test their embryos, and results of the tests can provide through emails.
This is just an ideal option if the technology is advanced enough for women to test embryos by themselves (home-care approach). This option might be involved with IA or technology to do self-check on their embryos. However, I did search online but it seems not available for pre-birth test.
Simon Fri 22 Nov 2019 10:08AM
This is a super thread. It's really great to see you building off each others work.
I was planning to collate your proposals today but my time has been taken up dealing with some family issues. So please accept my apologies - I'll get onto it tomorrow.
Daniel Brunt Sat 23 Nov 2019 6:35AM
Some really interesting points and already a lot of common ideas and thoughts. Sorry for the delay but I have been travelling. My policy options:
(1) Pre-birth testing for all that request it. No questions asked. Needs to be available to all and will more than likely need to be centrally funded. Could be offered through current midwifery services as an option.
(2) Evidence based education and public consultation on the circumstances in which abortion is acceptable. This would be very contentious and would need ongoing periodic consultation (5 yearly?) to test that the policy reflects the contemporary public thinking. Policy needs to be flexible enough to change with public perceptions.
(3) Mandatory testing for all pregnancies. Sounds a bit big brotherish but this information would be strictly for future funding decisions around anticipated stressors on the health system to ensure that adequate medical, mental and financial support is there for families who incur extra costs with special needs children. Information to be made available to parents if requested.
Izzy · Fri 22 Nov 2019 7:50AM
Great points from everyone! My three policy proposals are:
1) Drawing on a point made by @Jenna Robson, that funding should be prioritised for families who are either genetically or environmentally at risk of their child having severe developmental issues, or at risk of their child having some developmental issues that will be very costly to them (meaning that low-SES families will have higher priority). This will ensure that the families who will be the most strongly affected by the outcomes of pre-birth testing have access to it, giving them time to prepare for the future.
2) Drawing on points made about information access as well as @Margaret Aulda's second point about data-driven decision-making, that a public database should be developed to better aid families in identifying individual risks, and aid them in making decisions about a child's future (however, not intended to replace medical advice!). This database could cover all potential birth abnormalities and developmental differences, and would include information on long-term child outcomes to support families and allow them to plan in both the long-term and short-term (this, as well as supporting approaches 1 and 4, would hopefully enable more people to take Approach 2 because they would better be able to plan for their child's future). This database should also be updated frequently, allowing parents who may carry recently identified genetic diseases and the like to make fully informed decisions.
3) Alongside this mass of information for parents to draw on if they want, and support from medical professionals, there should also be plenty of family support available at the community level. This would mean forging stronger connections between community groups, including iwi and whanau, families, and health professionals. This would mean doing a number of things, including funding community groups that support new families and pregnant women like Plunket, and ensuring that health services and testing are well-tailored to communities (e.g. risks and considerations able to be explained in multiple languages including Te Reo, operating clinics in community locations, etc).