“Democracy, despite its limitations, is in the end the only way to ensure that policies do not simply benefit the privileged few.”
–Ha-Joon Chang
Fundamental to the question of the roles of the political system in policy making is the setup of the Swiss political system in and of itself. The government is split into three distinct branches, in order to enact a separation of powers: Legislature, Federal Chancellery as the Executive Branch, and the Federal Courts (Federal Council, 2015). Parliamentary sessions are held four times a year to enact or reject proposed legislation. The Judiciary Branch has civil and criminal branches, each dedicated to specific tasks in the enforcement of laws and punishment of legal infractions. The Executive Branch is responsible for implementation of legislation (Linder, 2010). The Swiss political system enables citizens to participate in all levels of politics, by way of popular initiatives and referenda. Initiatives are legislation proposed by the populace, whereas referenda are challenges to enacted legislation. This paper focuses on the interplay between policy-making and the political system, in the context of healthcare and bio-policy.
A study in health policy is illustrative of the dynamic interplay between the political system and public policy, and showed the significance of the scientific research community in pioneering new practices in treatment of heroin addiction. It had become generally recognized that certain groups of heroin users had persistent problems with addiction in spite of methadone therapy, and more important, “…heroin injectors had the highest rate of HIV infection in Europe” (Small et al, 2006). Even though the goal of the study was never drug abstinence, but rather improved retention in heroin-maintenance therapy, its success sparked a revolution in healthcare policy. The heroin maintenance program was expanded within Switzerland, and served as a landmark for other nations, including the Netherlands and Germany, to open their own studies in heroin-maintenance therapy (Small et al, 2006).
A further example presents itself in the form of bio-objects and bio-politics, concerning the use of umbilical cord blood (hereafter, UCB). The main use of UCB is in efforts to collect, screen, and bank haematopoeitic stem cells (HSCs), which have been critically important in the treatment of immune disorders, and reconstituting the immune system following treatment of bone marrow malignancies and other cancers (Brown, Williams, 2015). Public policy must rush to meet with the ethical demands of this technology, and research within this field. In that respect, one must ask where bio-politics intersect with public policy. Simply put, practically all scientific research is subject to government regulation. This difficulty is compounded by imprecision in the laws regulating research, challenges of enforcing laws in international research collaborations, and especially by the influence of special interest groups in the legislative branch (Marchant, Pope, 2009). Consequently, scientific research policy has required that knowledge gained from research sufficiently outweighs its ethical and biological costs, and these costs must be enumerated in research proposals.
In light of the above discussion, I believe it is fair to conclude that there is a complex interplay between policy-makers, and political systems. The difficulties inherent in providing adequate healthcare and conducting modern research serve as a concrete example of this dynamic. With such confounding factors as special interest groups (lobbies) and informed minorities (Scientific Research Committees), I wonder whether it is necessary to require politicians themselves to be scientifically literate, before any laws regulating research may be considered. For now, the status quo--the strategic deployment of expert scientific committees in the formulation of public health policy—must suffice.
Literature:
Brown, Nik, Williams, Rosalind, ‘Cord blood baking – bio-objects on the borderlands between community and immunity’, Life Sciences, Society and Policy (2015) 11:11, available from http://link.springer.com/article/10.1186/s40504-015-0029-8
Linder, Wolf 2010, Swiss Political System, available from www.wolf-linder.ch/wp-content/uploads/2010/11/Swiss-political-system.pdf
Marchant, Gary E., Pope, Lynda L., ‘The Problems with Forbidding Science’, Science and Engineering Ethics (2009), 15:3, 375-394, available from http://link.springer.com/article/10.1007/s11948-009-9130-9
Small, Dan, Ernest Drucker, and Editorial for Harm Reduction (2006), ‘Policy makers ignoring science and scientists ignoring policy: the medical ethical challenges of heroin treatment’, Harm Reduction Journal 2006, 3:16 available from http://www.harmreductionjournal.com/content/3/1/16
The Federal Council, How Switzerland’s Political System Works, September 18, 2015, available from: https://www.admin.ch/gov/en/start/federal-council/political-system-of-switzerland.html