Political Decision-Making in Switzerland. The Consensus Model under Pressure

This in-depth study of the decision-making processes of the early 2000s shows that the Swiss consensus democracy has changed considerably. Power relations have transformed, conflict has increased, coalitions have become more unstable and outputs less predictable. Yet these challenges to consensus politics provide opportunities for innovation.

Dominance, Competition, Compromise or Consensus? Explaining Decision-Making Structures

The previous chapter uncovered important differences between decision-making structures across the 11 processes investigated by this study. As we have noted, both historically and in much contemporary literature, the Swiss political system has been described as highly consensual. And yet, when we focus on differences between decision-making structures across different policy domains, important elements appear that point toward a more conflictual style of decision-making. Both when there is a power balance between coalitions and in the presence of a dominant coalition, coalition interactions are conflictual in the majority of cases. Based on the descriptive account of these differences in Chapter 4, the present chapter studies the conditions under which given decision-making structures emerge. Under which circumstances are actors able to form a dominant coalition, and which conditions lead to a situation where power is more evenly balanced between coalitions? Which conditions lead actors to develop a conflictual rather than a consensual type of interaction? Answering these questions can give us some indication of the factors responsible for different types of decision-making structures.

'Going Public': The Mediatization of Decision-Making Processes

In most Western countries, the media are said to exert an increasing influence on the political game. This development, which has been described variably as a shift towards an 'audience democracy' (Manin 1995) or the 'mediatization of politics' (Mazzoleni and Schulz 1999), emphasizes the increasing importance of the media for political actors and political decision-making. In such a context, political actors need to communicate with both the media and the public in order to gain support for their policy plans and to influence decision-making. The media were noticeably absent from Kriesi's (1980) in-depth analysis of political decision-making in Switzerland. This suggests that in the early 1970s, the media did not matter or mattered far less than they do today.

Looking beneath the Surface: Differences in Decision-Making Structures across Processes

The previous chapter presented the overall decision-making structure in Swiss politics at the beginning of the 21st century. This provides us with a general picture and allows for a comparison over time with the decision-making structure in the 1970s. However, the analysis of the overall decision-making structure potentially neglects important differences between policy domains (Atkinson and Coleman 1989; Knoke et al. 1996; Kriesi et al. 2006a; Sabatier 1987). Policy issues vary across policy domains, as do the political actors involved. In addition, actors may hold different policy preferences from one policy domain to the next, and they may also collaborate with other partners depending on the policy domain at stake. Examining differences between policy domains is particularly appropriate in Switzerland. Because no fixed coalitions of government and opposition exist, actors create different coalitions in each policy domain (Linder and Schwarz 2008). Whereas important parts of the institutional setting are similar across policy domains, decision-making structures might still vary. As was the case with the cross-time analysis conducted in the two previous chapters, a stability of 'rules-in-form' might hide important variations in 'rules-in-use' also across different policy domains.

Reactive, Slow and...Innovative? Decision-making Structures and Policy Outputs

Consensus democracies like Switzerland are generally known to have a low innovation capacity (Lijphart 1999). This is due to the high number of veto points such as perfect bicameralism or the popular referendum. These institutions provide actors opposing a policy with several opportunities to block potential policy change (Immergut 1990; Tsebelis 2002). In order to avoid a failure of a process because opposing actors activate veto points, decision-making processes in Switzerland tend to integrate a large number of actors with different - and often diverging - preferences (Kriesi and Trechsel 2008). Including a variety of actors in a decision-making process and taking into account their preferences implies important trade-offs. Integrating a large number of actors and accommodating their preferences takes time and carries the risk of resulting in lowest common denominator solutions. On the contrary, major innovative reforms usually fail or come only as a result of strong external pressures from either the international environment, economic turmoil or the public (Kriesi 1980: 635f.; Kriesi and Trechsel 2008; Sciarini 1994). Standard decision-making processes are therefore characterized as reactive, slow and capable of only marginal adjustments (Kriesi 1980; Kriesi and Trechsel 2008; Linder 2009; Sciarini 2006). This, in turn, may be at odds with the rapid developments of international politics, the flexibility of the private sector, or the speed of technological development.

European Union Trade Policy after Enlargement: Larger Crowds, Shifting Priorities and Informal Decision-Making

The article focuses on the effects of Eastern enlargement on EU trade policy-making. On interest constellation, the article makes a case that protectionist forces have been strengthened relative to liberal forces. This slight protectionist turn is mostly witnessed in the area of anti-dumping and with respect to the Doha trade round. On preference aggregation, guided by a principal–agent framework, it is argued that the growth in the number of actors (principals and interest groups) has not constrained the role of the European Commission (agent). However, it has led to an increase in informal processes and has empowered large trading nations vis-a`-vis smaller and less ‘comitology-experienced’ member states.

Structural and Institutional Determinants of Influence Reputation: A Comparison of Collaborative and Adversarial Policy Networks in Decision Making and Implementation

The central assumption in the literature on collaborative networks and policy networks is that political outcomes are affected by a variety of state and nonstate actors. Some of these actors are more powerful than others and can therefore have a considerable effect on decision making. In this article, we seek to provide a structural and institutional explanation for these power differentials in policy networks and support the explanation with empirical evidence. We use a dyadic measure of influence reputation as a proxy for power, and posit that influence reputation over the political outcome is related to vertical integration into the political system by means of formal decision-making authority, and to horizontal integration by means of being well embedded into the policy network. Hence, we argue that actors are perceived as influential because of two complementary factors: (a) their institutional roles and (b) their structural positions in the policy network. Based on temporal and cross-sectional exponential random graph models, we compare five cases about climate, telecommunications, flood prevention, and toxic chemicals politics in Switzerland and Germany. The five networks cover national and local networks at different stages of the policy cycle. The results confirm that institutional and structural drivers seem to have a crucial impact on how an actor is perceived in decision making and implementation and, therefore, their ability to significantly shape outputs and service delivery.

The Europeanization of Swiss Decision-Making Processes

Europeanization has been at the core of two research projects on decision-making processes in Switzerland that we carried out over the last decade. Interestingly enough, Europeanization was initially not supposed to be the central focus of these projects: The first was broader in scope, as it dealt with the effects of globalization and internationalization, and the second was agnostic with respect to Europeanization – it looked at the characteristics of the most important decision-making processes and structures in contemporary Switzerland, and at the related changes that have taken place since the 1970s. However, in both projects Europeanization has imposed itself as a crucial variable, if not as the most crucial variable. We use insights from these two research projects – and from a database on the legislative acts of the 1995-2006 period that emerged from these projects – to address the questions raised by the initiators of this debate and, more especially, to highlight what effects Europeanization has on decision-making processes and related power and conflict structures among actors.

Using technology to enhance decision making

We focus here on decision making in the everyday clinical situation and do not address decision making in politics and administration, although obviously it affects clinical practice and vice versa. For example, decisions against providing sufficient face-to-face psychotherapy is one factor that may increase the demand for Internet therapy, and vice versa—that is, the use of technology for therapy, as in Internet therapy, might influence to what extent face-to-face therapy needs to be provided. It is obvious that the aggregation of information for political and administrative decisions can take advantage of technology. If technology is used professionally, this should contribute to better informed decisions and less dependency on information provided by lobbyists who might not work in the interest of high-quality service for those who need it. An optimistic view is thus that technology works in favor of patients on this level as well. In the interest of keeping the focus of this chapter manageable, we also do not address treatments fully delivered over the Internet or computers, as for the example described in Comer and Barlow (2014), although such treatments, as they unfold, of course also include decision making.

[Molecular analyses for (early) recognition of hematologic diseases - sense and sensibility for molecular analysis: the art of intelligent decision-making]

During the last 10 years several molecular markers have been established as useful tools among the armamentarium of a hematologist. As a consequence, the number of performed hematologic molecular analyses has immensely increased. Often, such tests replace or complement other laboratory methods. Molecular markers can be useful in many ways: they can serve for diagnostics, describe the prognostic profile, predict which types of drugs are indicated, and can be used for the therapeutic monitoring of the patient to indicate an adequate response or predict resistance or relapse of the disease. Many markers fulfill more than one of these aspects. Most important, however, is the right choice of analyses at the right time-points!

Sharing decisions in breast cancer care: Development of the Decision Analysis System for Oncology (DAS-O) to identify shared decision making during treatment consultations

Shared Decision Making (SDM) is widely accepted as the preferred method for reaching treatment decisions in the oncology setting including those about clinical trial participation: however, there is some disagreement between researchers over the components of SDM. Specific standardized coding systems are needed to help overcome this difficulty.