Democracy, Ethics and Health Lab (DEH)
The Democracy, Ethics and Health Lab (DEH) studies how democratic values, public preferences, and ethical principles shape healthcare policy and decision-making. The lab combines empirical bioethics, public health ethics and policy analysis to examine how societies negotiate trade-offs between benefits, risks, and burdens in healthcare systems.
A central focus of the lab’s work is preference epidemiology, an emerging approach that systematically investigates how individuals and populations evaluate medical interventions and policy options, especially in situations involving complex trade-offs such as screening programs, resource allocation, and preventive interventions. By mapping thresholds of acceptability and variation in public preferences, this work aims to complement clinical evidence with evidence about citizens’ values, improving health communication and supporting more legitimate policy decisions (see e.g. "Perceptions and misconceptions of PSA screening in Switzerland: A preference epidemiology study" ).
DEH Lab also explores the ethical and institutional foundations of healthcare democracy, including mechanisms of public participation, deliberative processes, and citizen engagement in health governance. Beyond studying how participation can be implemented, the lab also engages with a deeper metaethical question under which democratic input enhances legitimacy and decision quality, and where it may introduce tensions with expertise, evidence, or minority rights.
Through mixed methods work, the lab develops conceptual frameworks and practical tools to support transparent, participatory, and ethically grounded health systems. In essence, the DEH Lab investigates how evidence, ethics, and democratic legitimacy interact in health governance.
Featured Publications
Spitale G, Germani F, Biller-Andorno N. 2025. "Introducing Preference Epidemiology: Improving Patient-Centered Approaches in Health Decision-Making". https://doi.org/10.3389/ijph.2025.1608617
Spitale G, Germani F, Biller-Andorno N. 2026. "Perceptions and misconceptions of PSA screening in Switzerland: A preference epidemiology study". https://doi.org/10.1016/j.socscimed.2025.118806
Germani F, Spitale G, Fischer C, Tag B, Reichenbach J, Devuyst O, Baumgartner M, Biller-Andorno N. 2025. "Healthcare resource allocation for rare diseases: an exploratory survey of Swiss citizens’ preferences". https://smw.ch/index.php/smw/article/view/4243
Spitale G, Biller-Andorno N, Germani F, Merten S. 2024. "Digital Democracy and Emergency Preparedness: Engaging the Public in Public Health". https://doi.org/10.3389/ijph.2024.1608004