Ethical considerations when involving older people in public service participation processes

In the United Kingdom, as in many other countries, New Labour governments have heavily promoted different forms of ‘service-user involvement’ in decision making about public services. The current orthodoxy would appear to be that involvement activities carry with them de facto benefits that are both affirmative and empowering. However, relatively little research has been carried out into considering the real impact (emotional or otherwise) of involving citizens in such processes. In this paper, the findings from a small-scale qualitative study led the authors to reflect that when outcomes of consultation are undesired and that when the precise role of those involved is left unclear in terms of purpose, responsibility and accountability, people can be left with powerful, often uncomfortable, feelings. The ethical dimensions of involving people without adequate, prior preparation or ongoing support are discussed, with suggestions made as to how public organisations can take an ethically sound approach to participation. Drawing on research ethics, and informed by the ethics of care, methods through which the potentially harmful effects of involvement can be mitigated are proposed.