ArticlePDF Available

Interpellated citizens: Suggested subject positions in a deliberation process on health care reimbursement

Authors:

Abstract

This article analyses how official citizen deliberation processes interpellate citizens, and argues that this act of invitation is a crucial element of the power dynamics of people's participation in such processes. The interpellation as citizen is both what offers people the opportunity to speak and a central aspect of how people's discourse is constrained and given direction. The study combines a discourse-theoretical perspective on interpellation and subject positions (Laclau and Mouffe) with frame-theoretical insights (Goffman), to analyse the way interpellation works in practice, how certain subject positions rather than others are indicated or prescribed to participants, and the ways these participants endorse them or attempt to (re)position themselves in interactions. Based on the analysis of a citizen deliberation process on health care reimbursement organised in Belgium, we show how the invited citizens are interpellated ? often simultaneously ? as 'nationals', as 'ordinary people', and as 'participants', and how they respond to this. On a theoretical level, this article contributes modestly to a more dynamic, multi-layered and subtle conceptualization of subject positions as constructed through suggestion, response and resistance in concrete interactive settings.
«Comunicazioni sociali», 2018, n. 1, 91-103
© 2018 Vita e Pensiero / Pubblicazioni dell’Università Cattolica del Sacro Cuore
MATHIEU BERGER - BENJAMIN DE CLEEN
INTERPELLATED CITIZENS*
Suggested Subject Positions in a Deliberation Process
on Health Care Reimbursement
The existing order coerces people not merely by physical force and material interests
but by overwhelming suggestion.
(M. Horkheimer and T. Adorno)1
Abstract
This article analyses how ofcial citizen deliberation processes interpellate citizens, and argues
that this act of invitation is a crucial element of the power dynamics of people’s participation in
such processes. The interpellation as citizen is both what offers people the opportunity to speak
and a central aspect of how people’s discourse is constrained and given direction. The study
combines a discourse-theoretical perspective on interpellation and subject positions (Laclau and
Mouffe) with frame-theoretical insights (Goffman), to analyse the way interpellation works in
practice, how certain subject positions rather than others are indicated or prescribed to partic-
ipants, and the ways these participants endorse them or attempt to (re)position themselves in
interactions. Based on the analysis of a citizen deliberation process on health care reimbursement
organised in Belgium, we show how the invited citizens are interpellated ‒ often simultaneously
‒ as ‘nationals’, as ‘ordinary people’, and as ‘participants’, and how they respond to this. On a
theoretical level, this article contributes modestly to a more dynamic, multi-layered and subtle
conceptualization of subject positions as constructed through suggestion, response and resistance
in concrete interactive settings.
Keywords
Citizen deliberation; participation; interpellation; discourse theory; interaction.
1. introduction
This article focuses on how citizen deliberation processes interpellate2 citizens as cit-
izens. This interpellation, we argue, is a crucial structuring element of such processes.
It is both what offers people the opportunity to speak (thus empowering them) and
a central aspect of how their talk is constrained and given direction (the exercise of
* Université Catholique de Louvain (UCL) ‒ m.berger@uclouvain.be; Vrije Universiteit Brussel (VUB)
‒ Benjamin.De.Cleen@vub.be.
1 M. Horkheimer, T. Adorno, The Dialectic of Enlightenment: Philosophical Fragments, Stanford: Stan-
ford University Press, 2002 (1944): 202.
2 L. Althusser, “Ideology and Ideological State Apparatuses: Notes towards an Investigation”, in Lenin
and Philosophy and other Essays, edited by L. Althusser, New York: Monthly Review Press, 1971: 121-176.
08_Berger-DeCleen.indd 91 25/01/2018 10:06:24
92 MAtHiEu BErGEr - BEnJAMin dE cLEEn
power on people). To paint a nuanced picture of the complex power dimensions of cit-
izen deliberation processes, the analysis takes into account how people’s invitation and
responses as citizens are tied up with broader discourses about citizenship and democ-
racy, as well as how the subject position of ‘citizen’ is produced and responded to in a
concrete interactive setting. To conceptualize this, we combine a discourse-theoretical
perspective3 on interpellation and subject positions with Goffmanian frame-theoretical
insights4 that allow analysing how positions are offered and signalled to participants,
and how they position themselves in response. Our empirical material is taken from a
Citizen Lab on health care reimbursement organised in Belgium in 2014 by the King
Baudouin Foundation5.
After some more general reections on power dynamics in citizen deliberation
processes, we turn to their subjective dimension and to the notion of ‘interpellation’.
We rst consider the potentials and some of the criticisms of Althusser’s work on inter-
pellation, and then move towards a more ‘positive’ or ‘productive’ (in Foucault’s sense)
and nuanced understanding of interpellative power, building on Laclau and Mouffe’s
discourse-theoretical view of subject positions. We then bring in Goffmanian insights
on speakers’ and hearers’ positions in interaction to allow for a more rened, dynamic
and multi-layered analysis of how interpellation happens in practice, and how people
respond to this. This gives us the basis for the empirical analysis of the different subject
positions of ‘citizen’ that are signalled and responded to by citizens in the Citizen Lab
we studied.
2. powEr in citizEn dELiBErAtion procEssEs
Citizen deliberation processes (labelled, for example, citizen parliament, consensus
conference and deliberative poll) have gained much traction in the last decades. This
has been explicitly envisaged as a way of renewing democracy through citizens’ di-
rect participation in policy-making, of extending citizen participation beyond electing
representatives, and as means of empowering citizens6. Simultaneously, since their
emergence and progressive institutionalization in many western countries’ public poli-
3 E. Laclau, C. Mouffe, Hegemony and Socialist Strategy. Towards a Radical Democratic Politics,
London: Verso, 2001 (1985); J. Glynos, D. Howarth, Logics of Critical Explanation in Social and Political
Theory, London: Routledge, 2007.
4 E. Goffman, “On Footing”, Semiotica, 25 (1979): 1-29; E. Goffman, Forms of Talk, Oxford: Basil
Blackwell, 1981; M. Berger, “The Politics of Copresence. An Ecological Approach To Resistance in Top
Down Participation”, European Journal of Political and Cultural Sociology, 2, 1 (2016): 1-22; M. Berger,
“Mettre les Pieds dans une Discussion Publique. La Théorie Goffmanienne de la Position énonciative Appli-
quée aux Assemblées de Démocratie Participative”, in Erving Goffman et l’Ordre de l’Interaction, edited by
D. Cefaï, L. Perreau, Paris: Presses Universitaires de France: 395-426.
5 The authors of this article were part of a team that was commissioned by the Foundation to undertake
a discourse analysis of this Citizen Lab. See B. De Cleen et al., Solidariteit en het Recht op Gezondheidszorg.
Een Discoursanalyse van het Burgerlabo over de Terugbetaling van Behandelingen in de Gezondheidszorg,
Brussel: Koning Boudewijnstichting, 2015. We would like to thank Laura Calabrese, Ignaas Devisch, François
Romijn and Leen Van Brussel for their input as co-authors of the report, and the Foundation (in particular
Tinne Vandensande, Gerrit Rauws and Pascala Prête) for the collaboration.
6 J. Habermas, The Structural Transformations of the Public Sphere, Cambridge, MA: MIT Press, 1989
(1962); C. Pateman, Participation and Democratic Theory, Cambridge: Cambridge University Press, 1970; J.
Mansbridge, Beyond Adversary Democracy, Chicago: University of Chicago Press, 1980; B. Barber, Strong
Democracy. Participatory Politics for a New Age, Berkeley: University of California Press; B. Manin, “Es-
quisse d’une Théorie de la Délibération Politique”, Le Débat, 33 (1985): 72-94; J. Cohen, “Deliberation and
Democratic Legitimacy”, in The Good Polity, edited by A. Hamlin, P. Petit, Cambridge: Blackwell, 1989.
08_Berger-DeCleen.indd 92 25/01/2018 10:06:24
intErpELLAtEd citizEns 93
cy-making (city planning, social welfare, health care, etc.), critical questions about the
power dynamics of these citizen deliberation processes have been constantly raised.
These too are usually rooted in democratic ideals7.
A rst range of critiques focuses on state-generated participatory processes’ dis-
connection from and lack of impact on actual decision-making. This extends from Sher-
ry Arnstein’s classic ‘ladder of participation’ article8 that denounced impotent partici-
patory processes as forms of ‘manipulation’ or mere ‘therapy’9, to recent ethnographies
that question public participatory processes’ aim to be ‘fun’ and ‘entertaining’10 and that
highlight how the set-up and group dynamics of these processes can lead to the collec-
tive elaboration of a ctional, illusory relation to the issues at stake11. From France to
the US, critiques of this light-hearted DIY democracy’, are concerned with the emer-
gence of a real “market of participation”12 or “industry of public engagement”13, and
with its distorting effect on democracy. Practices of state-led ‘e-democracy’ have not
been spared either. The futility of ‘comment posting democracy’ has been addressed, for
example by Jodi Dean in Democracy and Other Neoliberal Fantasies14. Her criticism of
‘commenting’ or ‘formulating ideas’ as an ineffective and powerless form of democratic
participation also extends to real-life citizen deliberation processes.
Many others have highlighted general logics of domination in the dynamics of de-
liberative processes themselves, and their impact on the legitimacy of subsequent deci-
sions. Led by feminist scholars15, these critiques have questioned gender biases, but also
the role of socio-economic inequalities and cultural differences in deliberative domina-
tion16. These critiques of citizen deliberation processes link up with broader critiques of
the communicative or deliberative democratic model (particularly Habermas’ theory of
deliberative democracy17, which has informed much citizen deliberation processes) and
build on alternative theories that stress the irreducible power dimension of democratic
engagement, such as Fraser’s ‘plural public spheres democracy’18, or Mouffe’s ‘ago-
7 N. Carpentier, Media and Participation. A Site of Ideological-Democratic Struggle, Bristol: Intellect,
2011, 13-63.
8 S. Arnstein, “A Ladder of Citizen Participation”, Journal of the American Institute of Planning, 35, 4
(1969): 216-224.
9 See also D. Chandler, “Active Citizens and the Therapeutic State: the Role of Democratic Participation
in Local Government Reform”, Policy and Politics, 29, 1 (2000): 3-14.
10 N. Eliasoph, Avoiding Politics. How Americans Produce Apathy in Everyday Life, Cambridge: Cam-
bridge University Press, 2008; N. Eliasoph, Making Volunteers. Civic Life after Welfare’s End, Princeton, New
Jersey: Princeton University Press.
11 M. Berger, “Des Publics Fantomatiques. Participation Faible et Démophobie“, Sociologies, January
2015. https://sociologies.revues.org/4935; M. Berger, J. De Munck, “Participer, entre Idéal et Illusion”, Re-
cherches Sociologiques et Anthropologiques, 46, 1 (2015): 1-24.
12 M. Nonjon, “Quand la Démocratie se Professionnalise. Enquête sur les Experts de la Participation”,
PhD diss., Université de Lille, 2006; J. Bonaccorsi, M. Nonjon, “La Participation en Kit: L’Horizon Funèbre
de l’Idéal Participatif”, Quaderni, 79 (2012): 29-44.
13 C. Lee, DIY Democracy. The Rise of the Public Engagement Industry, Oxford: Oxford University
Press, 2015.
14 J. Dean, Democracy and Other Neoliberal Fantasies. Communicative Capitalism and Left Politics,
Durham: Duke University Press, 2009.
15 See, among others L. Sanders, “Against Deliberation”, Political Studies, 25, 3 (1997): 347-376.
16 J. Knight, J. Johnson, “What Sort of Political Equality Does Deliberative Democracy Require?”, in
Deliberative Democracy, edited by J. Bohman, W. Rehg, Cambridge, MA: MIT Press: 279-319; M. Williams,
“Représentation des Groupes et Démocratie Délibérative: Une Alliance Malaisée”, Philosophiques, 29, 2
(2002): 215-249.
17 J. Habermas, Theory of Communicative Action, Boston: Beacon Press, 1984; J. Habermas, Between
Facts and Norms, Cambridge: MIT Press, 1996.
18 N. Fraser, “Rethinking the Public Sphere. A Contribution to the Critique of Actually Existing Democ-
racy”, Social Text, 25/26 (1990): 56-80.
08_Berger-DeCleen.indd 93 25/01/2018 10:06:25
94 MAtHiEu BErGEr - BEnJAMin dE cLEEn
nistic democracy’19. Others have put forward ways to alleviate domination and power
dynamics in participation; to go ‘beyond adversary democracy’20, towards a more ‘in-
clusive democracy’21.
3. intErpELLAtion: triGGErinG suBJEction
In critical analyses of how (state) institutions turn people into subjects of (dominant)
ideologies and of the fundamental power imbalances built into citizens’ relation to in-
stitutions, Althusser’s Ideology and Ideological State Apparatuses has become an im-
portant reference. Especially the concept of ‘interpellation’ (itself inspired by Lacan22),
developed in this article, is very productive:
All ideology hails or interpellates concrete individuals as concrete subjects, by the function-
ing of the category of the subject […]. I shall then suggest that ideology ‘acts’ or ‘functions’
in such a way that it ‘recruits’ subjects among the individuals (it recruits them all), or ‘trans-
forms’ the individuals into subjects (it transforms them all) by that very precise operation
which I have called interpellation or hailing, and which can be imagined along the lines of
the most commonplace everyday police (or other) hailing: “Hey, you there!”
Assuming that the theoretical scene I have imagined takes place in the street, the hailed in-
dividual will turn round. By this mere one-hundred-and-eighty-degree physical conversion,
he becomes a subject23.
Althusser’s concept of interpellation helped open the door towards a conceptualization
of ideology as not only subjecting people but also producing them as subjects (devel-
oped later by Foucault, for example)24. Also, his argument that ideology, interpellation
and the reproduction of ideology by subjects are a matter of practice that ideology
functions through language (in the broad sense), rituals, behaviour, which, as Hall notes
“always appear in social sites, linked with social apparatuses25 has great value for
analyses of concrete institutional settings such as citizen deliberation processes.
But Althusser’s conceptualisation of ideology and interpellation has also been crit-
icised. For our purposes, one important criticism is that Althusser’s understanding of
interpellation does not apply properly to less formally coercive and more ‘positive’ in-
terpellations. In his ethnography of an urban Jewish Orthodox community, Iddo Tavory
argues that:
A juridical summoning is too violent an image. Social life has its moments of coercion. But
[…] although the question of “what would the (Orthodox) neighbor think?” is an aspect of
much of religious summoning, it would be simplistic to claim that power dynamics always
form the core of such moments. What the juridical metaphor misses and what religious
“summoning” better captures, is the sense of fullment, responsibility, moral failure and
19 C. Mouffe, “Deliberative Democracy or Agonistic Pluralism”, Social Research, 66, 3 (1999): 745-758.
20 Mansbridge, Beyond Adversary Democracy.
21 I. Young, Inclusion and Democracy, Oxford: Oxford University Press, 2000.
22 J. Lacan, Ecrits: A Selection, translated by E. Sheridan, New York: International, 1977.
23 Althusser, Ideology and Ideological State Apparatuses: 173-174.
24 See S. Hall, “Signication, Representation, Ideology: Althusser and the Post-Structuralist Debates”,
Critical Studies in Mass Communication 2, 2 (1985): 91-114 (102).
25 Hall, “Signication, Representation, Ideology”: 99; J. Butler, The Psychic Life of Power: Theories in
Subjection, Stanford: Stanford University Press, 1997, 5.
08_Berger-DeCleen.indd 94 25/01/2018 10:06:25
intErpELLAtEd citizEns 95
elation that being summoned can sometimes entail. […] We need to be able not to reduce
participation and identication to […] a dour command26.
Related to this, there is the argument that Althusser leaves insufcient margin of in-
terpretation (or misrecognition, or failure to hear the call, or resistance) to the hailed
individual27. He has also been criticised for limiting ideology to the ideology of the
dominant class and for ignoring alternative ideologies28. Moreover, there is a danger in
Althusser’s insistence that ideology works through practice of equating the practice of
following the rules (of speaking or acting in a certain way or at least not defying those
ways of speaking or acting) or of responding to an interpellation with the belief in or
identication with ideology29.
4. intErpELLAtion: suGGEstinG suBJEct positions
We believe that the notion of interpellation has signicant potential for a critical ap-
proach of top-down participatory processes, but for this potential to be fully realised, the
limitations discussed above need to be transcended.
Answers to this can be found in the work of Laclau and Mouffe who moved beyond
traditional Marxism’s negative denition of ideology as well as beyond Marxist class
reductionism. Further developing Althusser’s theorization of how ideology produces
subjects, and building also on Foucault, Laclau and Mouffe30 have theorized how dis-
courses offer ‘subject positions’. Discourse theory sees a discourse as a “social and po-
litical construction that establishes a system of [meaningful] relations between different
objects and practices, while providing (subject) positions with which social agents can
identify”31. Discourse theory thus further developed how interpellation ‒ whilst not al-
ways calling it such – functions as a more ‘positive’, ‘formative’ process of constituting
human subjects through discourse. Combined with discourse theory’s insistence on how
a person is simultaneously interpellated by, and can identify with, positions offered by
different discourses (e.g. mother, member of the nation, member of the working class),
this also implies more agency32.
However, discourse theory remains strongly focused on political rhetoric and strat-
egy. To facilitate an empirical analysis of addressees’ concrete answers to these offered
positions, and certainly for the analysis of interpellation in a citizen deliberation pro-
cess, we want to combine discourse theory with a more interactionist approach. By
bringing in Goffman’s work on positions in interaction – what he calls ‘footings’33 – we
can also further rene the notions of subject position and interpellation. Attention shifts
towards how subject positions are offered, in situation and in practice, as positions from
which to speak (or not speak, and listen) in a particular manner and using certain reg-
26 I. Tavory, Summoned. Identication and Religious Life in a Jewish Neighborhood, Chicago, Univer-
sity of Chicago Press, 2016, 6-7.
27 Butler, Psychic Life, 95.
28 Hall, “Signication, Representation, Ideology”: 99.
29 See J. Butler, Psychic Life, 106-131.
30 Laclau, Mouffe, Hegemony and Socialist Strategy.
31 D. Howarth, Y. Stavrakakis, “Introducing Discourse Theory and Political Analysis”, in Discourse
Theory and Political Analysis, edited by D. Howarth, A. Norval and Y. Stavrakakis, Manchester: Manchester
University Press, 2000: 3.
32 Glynos, Howarth, Logics of Critical Explanation, 119.
33 Goffman, Forms of Talk, 124-125.
08_Berger-DeCleen.indd 95 25/01/2018 10:06:25
96 MAtHiEu BErGEr - BEnJAMin dE cLEEn
isters (and not in another manner or using other registers); to how these positions are
called or signalled, in often quite mundane and subtle ways.
By looking at how people take up particular positions and speak from them, insight
into how and to what extent people identify with a range of subject positions and what
this implies for how they speak is further strengthened. Bringing in an interactionist
approach indeed allows analysing in a more concrete manner what it means for a citizen
to cope with, combine, and navigate the various and multi-layered positions he or she
is invited and expected to adopt. In this manner, combining discourse theory and inter-
actionist insights also strengthens, renes, and nuances critical views on citizen delib-
eration by confronting macro criticisms with concrete, complex, ambiguous situations,
and with more subtle and less univocal, imperative or coercive forms of interpellation.
5. MEtHod And MAtEriAL
Our analysis of interpellation in citizen deliberation processes takes its empirical mate-
rial from a so-called Citizen Lab on health care reimbursement organised by the Belgian
King Baudouin Foundation in the autumn of 2014. Throughout three weekends, 32 Bel-
gian citizens discussed the allocation of resources among health care treatments. In the
Citizen Lab, like in other citizen deliberation processes, people’s talk is:
invited and hosted by an institution (the King Baudouin Foundation, at the re-
quest of the RIZIV/INAMI ‒ the National Institute for Sickness and Invalidity Insurance,
which decides about health care reimbursements);
‒ framed by and expected to adhere to a series of objectives, a particular focus and
practical rules dened by the organisers and facilitators (focused on integrating citizens’
voice in decision-making procedures regarding health care reimbursement);
‒ produced in interaction with the talk of other actors (in the Citizen Lab: organis-
ers, invited experts and stakeholders, facilitators, and ‘content facilitators’).
The talk produced by citizens in deliberative processes can therefore only be un-
derstood as a response to the invitation by institutions, as the product of interaction,
contingent on and situated in a particular interactional setting. This raises questions
about the deliberative citizen himself or herself, as an ambiguous subject. This person
is ‘called into being a citizen’ by the soliciting institutions. It is in the tension between a
passive process of subjection and recruitment by the institution, and an active process of
subjectivation and role-taking that the invited people become citizens.
Our analysis of how this happens in the Citizen Lab is based on an analysis of re-
cordings and transcriptions (a total of 397,323 words) and also integrates ethnographic
observations. Our analysis combines a discourse-theoretical and frame-theoretical con-
ceptual framework with the coding procedures of constructivist grounded theory34. This
allows for an open-ended but theoretically informed coding process that integrates con-
cepts from discourse theory and frame theory as well as concepts that help to understand
citizen deliberation as sensitising concepts (that point us to relevant parts and aspects of
the material and allow to interpret that material).
34 K. Charmaz, Constructing Grounded Theory, 2nd ed., Los Angeles: Sage, 2014; see N. Carpentier, B.
De Cleen, “Bringing Discourse Theory into Media Studies”, Journal of Language and Politics, 6, 2 (2007):
267-295.
08_Berger-DeCleen.indd 96 25/01/2018 10:06:25
intErpELLAtEd citizEns 97
6. tHE suBJEct positions of tHE citizEn: invitAtions And rEsponsEs
The term Citizen Lab makes clear that people are invited to participate as citizens. But
what does this interpellation as citizen entail? Which place and which subject position
does the Citizen Lab offer to the participating citizens to identify with and to speak
from? Which dimensions of citizenship remain absent, are not stimulated, or even cen-
sored? And how do the citizens respond to these calls, indications, and suggestions to
speak this way or that way, from this or that position?35
The interpellation as citizen in the Citizen Lab is complex and multi-layered.
We distinguish between three main subject positions: the citizen-as-national, the citi-
zen-as-ordinary individual, and the citizen-as-participant. These three positions inter-
act and complement each other, and are closely articulated in the Citizen Lab. But we
consider them as analytically distinct because they each offer citizens different and rel-
atively autonomous positions from which to speak, and because speaking from each
of these three positions has particular implications for how citizens talk. These three
positions are mainly signalled – produced, called, expected, evaluated – without much
explicit or sustained reference to discourses about citizenship, but are nevertheless con-
nected to three discourses that come together in the Citizen Lab: a nationalist discourse
(the citizen as national), a citizen deliberation discourse that borrows from a broader
deliberative democratic discourse (the citizen as ordinary individual who discusses the
general interest) and the discourse of citizen participation (the citizen as a participant in
a collective harmonious and constructive experience).
6.1. Citizens as Nationals
Firstly, the Citizen Lab invites people as Belgian citizens. Even though representative-
ness in the strict sense is explicitly not an aim of the Citizen Lab, the group is construct-
ed so as to roughly represent the make-up of Belgian society: 50% French speakers
and 50% Dutch speakers, a balance between the sexes and age-groups, a degree of
ethnic-cultural diversity.
The simple fact that many discussions are held in separate monolingual groups
also interpellates people as French-speakers or Dutch-speakers, as Flemings or Franco-
phone Belgians (which, among other things, neglects a bilingual political community
like Brussels-Region where many people do not easily t into one of these categories).
However, this linguistic-cultural identity, which plays a central role in Belgian politics
(with the richer Flanders questioning its ‘solidarity’ with the poorer South, Flemish
nationalists criticizing the Francophones for being spendthrift, etc.), is hardly politi-
cized during the Citizen Lab. This is connected to a broader absence of strong political
cleavages in the Citizen Lab (6.2.1), as well as to the how citizens are interpellated as
collaborative and constructive ‘participants’ (6.3).
The Citizen Lab’s interpellation of citizens-as-nationals thus reproduces both Bel-
gium as a nation-state, and the belief that two language-based sub-state national groups-
make up the Belgian nation. This is not an entirely banal nationalism36, however. In a
context of constant tension and division between Dutch-speaking and French-speaking
35 M. Berger, “Répondre en Citoyen Ordinaire. Pour une Étude Ethno-Pragmatique des Engagements
Profanes”, Tracés, 2, 15 (2008): 191-208.
36 M. Billig, Banal Nationalism. London: Sage, 1995.
08_Berger-DeCleen.indd 97 25/01/2018 10:06:25
98 MAtHiEu BErGEr - BEnJAMin dE cLEEn
political representatives in Belgium, the Citizen Lab constitutes a rare occasion to join a
public discussion as a member of the national community, and to have a say about fed-
eral matters. This is related to the King Baudouin Foundation’s identity as an explicitly
bilingual Belgian institution (named after and nanced by the former King of Belgium,
Baudouin).
6.2. Citizens as Ordinary Individuals
The invitation as citizen in the Citizen Lab is signicantly richer than the mere invitation
to speak as an inhabitant of Belgium. The Citizen Lab (like many other citizen delibera-
tion processes) is conceived as a partial alternative for and complement to representative
democracy and technocratic, elite-driven decision-making that are considered to insuf-
ciently take into account the opinions of citizens. The Lab appeals to citizens’ sense of
civic duty (they invest three full weekends on discussions about health care), whilst si-
multaneously stressing their ordinary37 character as people who have no particular inter-
ests or expertise in healthcare. The notion of citizens indeed acquires meaning through
its distinction from politicians, stakeholders and experts (categories of people that are
also citizens in the strictly legal-national sense). The Citizen Lab does invite political
and civil society representatives, pharmaceutical company representatives, patients and
patient representatives, and medical experts, but these are invited as categories of people
that are clearly set apart from the ordinary citizens. There are three dimensions to this
ordinariness.
6.2.1. Political Ordinariness
To be an ordinary citizen, rst of all, implies not being a political actor. The entire set-up
of the Citizen Lab is to have citizens’ opinions heard more directly in health care poli-
cy-making. People are invited to speak as a sample of the ordinary Belgian citizens, and
about the general interest of the Belgians, and in that sense as representatives of the Bel-
gian citizenry38. The category of the ordinary citizen is thus constructed in opposition
to actors that represent particular interests: political parties, civil society organisations,
interest groups.
But the a-political character of the ordinary citizen goes further than not being in
any way a political actor: people are never invited by the facilitators to express their
(party-)political preferences, and are indeed discouraged from speaking about political
parties, governments, or other political actors (these are “out of the framework”, as the
facilitators say). Moreover, people are invited to speak about values (equality, for exam-
ple) in the abstract sense, without connecting these to the political ideologies (socialism,
for example) and organisations representing such values (socialist parties, for example).
Citizens largely accept the organisers’ framing of the issue and formulation of
questions, the limitations of the scope of the Citizen Lab to priority setting within a
context of a limited budget. Citizens even police discussions themselves by labelling
certain issues as “outside of the framework”. However, they also show some degree of
37 M. Berger, J. Charles, “Persona Non Grata. Au Seuil de la Participation”, Participations, 9 (2014):
7-35.
38 As Hannah F. Pitkin would put it, they are considered as “standing for” rather than “speaking for” the
broader population (The Concept of Representation, Berkeley: University of California Press, 1967).
08_Berger-DeCleen.indd 98 25/01/2018 10:06:25
intErpELLAtEd citizEns 99
deance towards all this. For one, despite the focus on criteria for reimbursement and
the exclusion of the organization of health care as a topic, citizens continue to speak, for
example, about what they considered the exorbitant prices charged by pharmaceutical
companies. They also reect on how changes to the health care system would alter the
budgetary context.
The stakeholders and experts invited to speak at the Citizen Lab – including people
with particular interests and political proles, such a representative of the pharmaceuti-
cal industry and of the socialist health insurance provider – refer to the political context
much more (than the facilitators) in their presentations and argumentations, bringing in
political reality in a largely depoliticised setting, so to speak. But this is not structural-
ly included in discussions with the citizens, and even kept outside of the scope of the
Citizen Lab very explicitly by the facilitators. Nevertheless also taking into account
that citizens do speak out about issues that the facilitators prefer to keep outside of dis-
cussion (e.g. the role of pharmaceutical companies in the decision-making process) – it
remains remarkable that citizens hardly bring traditional political ideologies and vo-
cabulary (socialism, liberalism, the notions of Left and Right, progressive and conserv-
ative) or the political eld (political parties, governments, civil society organisations)
into the discussions.
6.2.2. Epistemic Ordinariness
A second dimension of ordinariness is epistemic: citizens are considered as ‘averagely’,
‘normally’ informed about the topic of health care. Again, this acquires meaning in re-
lation to what citizens are not: experts. In fact, a number of participants were active in
the medical sector (a nurse, a veterinarian) or were studying medicine, but the organisers
did not draw on their specic knowledge. Quite on the contrary, their medical profession
and study were kept in the background.
Like other deliberative processes that discuss complex matters with citizens that
are invited for their ordinariness, the Citizen Lab has to nd a way to a) make discus-
sions on the topic possible without turning the citizens into experts, b) make the output
of that process as useful as possible to stakeholders without undermining the layperson
quality of the citizens and of the talk they produce. This section reects on the ambigu-
ities and tensions inherent to the invitation of citizens to discuss complex issues, and on
citizens’ reactions to this ambiguous invitation39.
Citizens were given both medical-scientic input and information about the deci-
sion-making process. The former kind was mainly information on the pathologies and
treatments used as cases for discussion (e.g. Alzheimer, orthodontic treatments). Input
about decision-making was more structural to the process, which revolved around a
terminology that aimed to produce an output that could a) be easily integrated into the
decision-making process, b) aid to restructure the decision-making process and make
it more sensitive to the citizens’ concerns. This terminological framework revolved
around notions such as criteria (for determining what to reimburse and what not; e.g. ef-
fectiveness and medical need), values (underlying those criteria, e.g. solidarity, individ-
ual responsibility), and preconditions (for an individual getting a treatment reimbursed;
e.g. prescription by a doctor).
39 See: M. Berger, F. Romijn, “Participer ou Presque. Préciser les Ambiguïtés de la Participation dans le
Domaine Médical”, Questions de Communication, 30 (2016).
08_Berger-DeCleen.indd 99 25/01/2018 10:06:25
100 MAtHiEu BErGEr - BEnJAMin dE cLEEn
Citizens’ talk was to a signicant extent structured around this proposed terminol-
ogy. But, in part due to the inherent complexity and ambiguity of these notions (also to
the facilitators), this terminology did not function as a straightjacket. This ambiguity
also allowed citizens to use terminology rather creatively. For example, when citizens
evacuated ‘criteria’ they had trouble with, for moral-ideological reasons (for example
‘age’ as a criterion for whose health care should be reimbursed or not) they several times
contested that such notions would qualify as criteria from a terminological perspec-
tive. Moreover, the facilitators did alter the overarching terminological framework in
response to citizens’ talk. And citizens had much more impact on the names of concrete
criteria, values and conditions.
Citizens were also given input on some elements of the terminology specic to
health care reimbursement decision-making: for example measures used to determine
the cost-effectiveness of a health care intervention. These notions as well were not un-
derstood unanimously by the citizens. Some citizens used them incorrectly, and were
corrected by facilitators or experts. Others did not use these notions at all, at least partly
because they were too complex. Interestingly, certain citizens also outright contested
these complex notions for being “simplistic and tendentious”. We see here that despite
its very strong impact on citizens’ talk, the introduction of a specialised vocabulary does
not automatically afrm the inequality between specialists and non-specialists.
6.2.3. Ordinariness as the moderation of personality and personal interest
Getting involved as a citizen essentially means participating in a discussion by express-
ing individual opinions about the general interest in a non-political and non-expert man-
ner (“I think that…”, “I believe that…”, “In my opinion…”, etc.). This can be done by
speaking as an individual citizen, which is different from speaking politically—as a par-
ticular ‘we’ both in the strict sense (e.g. ‘we, socialists’) and in the broader sense of repre-
senting a particular demographic (‘we, poor people’, ‘we, old people’). It is also different
from speaking in the authoritative voice of the expert, using a specialised vocabulary.
We need to distinguish here between speaking as an individual and speaking as a
person with particular experiences and interests. Generally speaking, the ‘person behind
the citizen’ is only present to a certain extent (a name, face, voice; sometimes basic
information about professional life, family situation, education, etc.) as this personal
presence is regulated by the organisers and by the citizens, where citizens are required
to exercise moderation in bringing out the personal.
Invitations to speak from personal experience are not absent, but do not structure
the discussions. The formats used in the Citizen Lab are rather built around sharing
individual opinions voiced in a more abstract manner. This allows ‘ordinary’ people to
partake in discussions about health care policy usually reserved for politicians and pro-
fessionals. But the moderation of the personal also weakens citizens’ authority as speak-
ers, in two ways: a) by hindering people’s rooting of their talk in personal experiences,
and b) by having people express themselves in a more abstract and technical jargon that
is relatively far from their own registers. This also reinforces the political ordinariness
in that it moderates people, inviting them to give individual opinions about the general
interest rather than speak about their own personal (individual or group) interests, root-
ed in their own experiences.
Whilst largely speaking in the manner suggested to them, citizens do sometimes
go beyond these ‘individual contributions’ to forms of participation that are closer to
08_Berger-DeCleen.indd 100 25/01/2018 10:06:25
intErpELLAtEd citizEns 101
‘personal involvements’40. Citizens do regularly draw on their experiences. Some draw
on professional experiences with health care to support their arguments (“I have my
professional life that has allowed me to see quite some patients…”). Others mobilise
experiences with people they know. Sometimes people also draw on experiences with
diseases and treatments. Certain citizens that remain quiet and invisible and seem less at
ease with the more abstract terminological framework, speak almost exclusively when
they can speak about concrete issues on the basis of personal experiences. For example,
one young woman who hardly spoke during the Citizen Lab, did speak extensively
about the reimbursement of orthodontic care based on her experiences with braces.
However, references to personal experience are often made in a moderate manner,
brought up eetingly by speakers in debates that structurally revolve around the abstract
notions of ‘criteria’ and ‘values’ indicated by the Citizen Lab. At times, citizens pro-
duce meta-pragmatic reections on how ‘personal’ their contributions should be. Some
believe that it is good to share experiences. Others express the opinion that mobilizing
personal experiences would be detrimental to citizens’ contributions: “If I say, ‘look,
my mother died of cancer’, well everything in our discussions about health care will be
related to cancer. I would lock myself with that and I would forget that there are rare
diseases and other kinds of problems [that affect other people]”.
Citizens are thus not only disciplined, they also discipline themselves as far as
referring to personal experiences and their personal life goes. This excerpt also clearly
shows how the moderation of personal experience is connected to political ordinariness
and the aim to speak about the general interest rather than about one’s own individual
or group interest.
6.3. Citizens as Participants
Last but not least, the participants in the Citizen Lab are also interpellated as exactly
that: participants. That is to say, as co-agents in a joint activity, but also as the members
of a community of experience that is created and that evolves throughout the weekends
of the Citizen Lab. In this manner, people who are mobilized as individuals, and who
are invited to express their individual opinions about the general interest as opposed to
any sub-collective’s interest, do constitute a group together, and form a collective sub-
ject, a team. As a format, the Citizen Lab strongly stimulates a harmonious and friendly
group dynamic. This is sometimes very explicitly highlighted, stimulated through joint
dinners, and even game-like formats meant to enhance sociability, and permanently
signalled in more subtle ways.
The position of citizen-participant is produced by a citizen deliberation process that
aims to involve ordinary individuals in decision-making. However, the position of citi-
zen-as-participant in such a particular process is also something very different because
it is no longer only about getting involved in the public sphere, talking about public
problems, but also about identifying as member of a particular and closed group, and
about contributing to the smooth and harmonious functioning of that particular group.
Citizens often speak in the ‘we’-form to refer to the 32 citizens that participate in
the Citizen Lab. But sometimes the ‘we’ also refers to the entire group of participants
40 J. Zask, Participer, Essai sur les Formes Démocratiques de la Participation, Paris: Le Bord de l’Eau,
2011.
08_Berger-DeCleen.indd 101 25/01/2018 10:06:25
102 MAtHiEu BErGEr - BEnJAMin dE cLEEn
in the Citizen Lab experience. This includes facilitators and to some extent organizers,
but excludes the invited experts or stakeholders who are invited only during part of the
Citizen Lab and are not part of the community of experience.
The group dynamic strengthens the interpellation as citizens that come together to
speak for the Belgian population, for the general interest. At the same time, this ‘we,
the participants’ and the concern with the harmony within that group seems to preclude
speaking in the name of a societal sub-group, or at least contributes to making such a
representative claim less likely. Citizens only very rarely use the ‘we’ to speak as mem-
ber of a certain sub-group among the 32 citizens or of Belgian society.
The Citizen Lab is characterised by the absence of much conictual and explicitly
political talk that might endanger the collaborative spirit of the Citizen Lab. For one,
citizens hardly refer to other sub-groups of the population (‘we, the poor’, ‘we, the
people of immigrant descent’, ‘we, the pensioners’) nor to political afliations (‘we, the
socialists’, ‘we, the liberals’...). The ‘we’ is also rarely mobilised to refer to and speak
as the sub-groups of Francophones and Dutch-speaking Belgians, despite the practical
importance of these linguistic differences for discussion formats and despite their bla-
tant political importance for debates on health care in Belgium. There are reections on
how linguistic differences sometimes make the debates practically difcult, as well as
humoristic and playful remarks about the differences between Flemings and Franco-
phones. But these do not stand in the way of the formulation of joint positions. At the
end of the Citizen Lab, one of the French-speaking participants states that:
Finally, […] with this mix of persons from different communities […], one thing is clear that
comes out of this […]: in the end the only thing that separates us is language. We agreed on
all issues […] there was a certain community of ideas. In the end, what separates the groups,
is only language. Voilà.
This speaking as ‘we’ becomes most visible in moments where the citizens speak about
themselves as citizens to other groups: when they address stakeholders, enter into dia-
logue with experts, or speak explicitly about how their opinions, as a group of citizens,
relate to those of experts and stakeholders. Whereas party political or linguistic-cultural
identications and oppositions would highlight differences between citizens and possi-
bly endanger collaborative group dynamics, the juxtaposition of the general interest (as
voiced by citizens) and the pharmaceutical industry’s interests, for example, enhances
the group identication and cohesion between citizens.
7. concLusion
Our analysis has shown how the interpellation of citizens as citizens and people’s re-
sponses to this interpellation are a crucial dimension of the multi-layered and ambig-
uous power dynamics in institutionalized civic participation. The different dimensions
of the interpellation as citizen in the Citizen Lab we analysed had a profound impact on
what citizens said about the issue of health care reimbursement, on how they made sense
of the issue, as well as on the registers they used to speak about it.
Our analysis also shows that the citizens’ talk is not entirely determined by how
institutions interpellate them. Citizens go beyond the registers offered to them, and go
beyond the framework they are supposed to remain within. However, in so doing citi-
zens usually draw on the subject positions of citizen offered by the process, even if they
08_Berger-DeCleen.indd 102 25/01/2018 10:06:25
intErpELLAtEd citizEns 103
use these positions to go somewhat beyond what the organizers had in mind. Moreo-
ver, these occasional transgressions of the suggested subject positions seem to function
largely as exceptions to the rule or as relatively minor diversions. In the Citizen Lab, the
overall response to interpellation may be summarised as follows: “by having accepted
the invitation to this process, we now agree to follow (roughly) the host’s guidelines
and suggestions, including those that regard who we are supposed to be in this process”.
The meaning of the interpellation as citizen can be understood only by considering
how people practically used and articulated the three offered subject positions, that is,
how they talk at the same time as ‘nationals’, as ‘ordinary individuals’ and as ‘partici-
pants’. Even though the three dimensions related to the ‘citizen’ subject position could
have clashed in other circumstances (for instance, the citizen-as-national and the citi-
zen-as-happy-participant in a nation-state as divided and contested as Belgium), in the
Citizen Lab, they were articulated relatively smoothly and seamlessly.
The participation discourse, and the attempts to host and organise a pleasant and
friendly process on three weekends, were coherent with the underlying ideal of national
unity. What was to be built was the team in itself, and a shared view of citizens on health
care reimbursement (even if the Foundation stressed that consensus was not an aim of
the process, the organisation of the process did push in that direction). Most people
participated in this spirit, without (overtly) questioning it, and most of them enjoyed (or
seemed to enjoy) it.
The citizen deliberation discourse, valuing the ordinary citizens’ contributions
made in the mode of intuitive, impersonal, un-opinionated opinions, proved to be very
complementary with the ‘national’ and the ‘participation’ discourses. Whereas strong
political, knowledgeable and personal engagements tend to create cleavages within the
group and between mutually exclusive positions, contributions ‘in a minor mode’ can
be considered as vaguely compossible41. Ordinary must thus be seen as a certain format
for contributions, that facilitates their aggregation in a relatively unied outcome: here,
the list of ‘criteria’ and ‘values’ supposed to summarize the citizens’ views on health
care reimbursement.
Whilst taking a particular form, the interpellation of citizens in the Citizen Lab has
important similarities with other citizen deliberation processes, as well as with other
forms of citizen participation42. In combination with the observation that citizens largely
‘accept’ the invitation addressed to them, this points to the degree to which the discourse
and practice of citizen deliberation processes need to be understood within the context
of broader dominant ideas about and practices of citizen participation in politics and
policy-making. This also implies that the interpellation of citizens as citizens, beyond
a very explicit initial invitation in a Citizen Lab, and some more explicit reminders
throughout, need not be signalled all that explicitly or authoritatively throughout the
process to be effective, but can rely on much subtler and ‘positive’ forms of interpella-
tion. But although the interpellation as citizen is a far cry from the policeman hailing
a person on the street, inviting people to participate in a Citizen Lab does constitute a
form of interpellation, and approaching it as such, we hope to have shown, contributes
to understanding the nature of citizen participation in deliberative processes and the
complexity of the power dynamics of such forms of participation.
41 Berger, Publics Fantomatiques.
42 See N. Carpentier, W. Hannot, “To Be a Common Hero. The Uneasy Balance between the Ordinary
and Ordinariness in the Subject Position of Mediated Ordinary People in the Talk Show Jan Publiek”, Inter-
national Journal of Cultural Studies, 12, 6 (2009): 597-616.
08_Berger-DeCleen.indd 103 25/01/2018 10:06:25
ResearchGate has not been able to resolve any citations for this publication.
Chapter
This chapter discusses the politics of multiculturalism as a kind of identity politics. It argues the concept of structural difference, as distinct from cultural group. Analysing structural difference and structural inequality, then, helps to show why these movements are not properly interpreted as identity politics. The chapter defines social structure, and more specifically structural inequality, by rebuilding elements from different accounts. Norms of inclusive communicative democracy require that claims directed at a public with the aim of persuading members of that public that injustices occur must be given a hearing, and require criticism of those who refuse to listen. Common good theorists no doubt fear that attending to group differences in public discussion endangers commitment to co-operative decision-making. Only explicit and differentiated forms of inclusion can diminish the occurrence of such refusals, especially when members of some groups are more privileged in some or many respects.
Article
The globally unfavourable assessment of state-generated forms of participation often extends to the citizens’ talk in itself. Today, it is the very idea that ordinary citizens are able to express themselves in a relevant and fruitful way during technical and tightly framed public discussions that seems to be called into question. How do citizens respond to the difficulty to express their ideas or concerns about their neighbourhood, in a forum where they have been invited to do so? What are their reactions to repeated failure to impact the discussions and the projects? ‘Exit’, ‘voice’ and ‘loyalty’ are three typical reactions to dissatisfaction. This paper will describe a fourth option, ‘internal resistance’. Following this option, citizens, while conserving appearances of loyalty, resituate themselves in the interaction through tactical moves that are found to each illustrate one of the main principles of Goffman's conception of the ‘interaction order’: focusing, mutuality, equality.
Article
This essay attempts to assess Althusser's contribution to the reconceptualization of ideology. Rather than offering a detailed exegesis, the essay provides some general reflections on the theoretical gains flowing from Althusser's break with classical Marxist formulations of ideology. It argues that these gains opened up a new perspective within Marxism, enabling a rethinking of ideology in a significantly different way.