Committee reports constitute a common descriptive measure of public committees’ contributions, and federal public committees produce scores of reports and recommendations, as Figure 8.1 suggests. When it works, however, participatory bureaucracy offers more than dense government reports filed in agency archives or university libraries. It liquefies knowledge and makes policy public by bringing permeability to bureaucratic administration, which supports task implementation. Has public participation for pharmaceutical regulation and educational assessments been able to liquefy knowledge, promote competent implementation, or both?

The Food and Drug Administration, like other agencies, justifies its consultations with public advisers in terms of expertise and reputation: “The primary role of an advisory committee is to provide independent advice that will contribute to the quality of the agency’s regulatory decision-making and lend credibility to the product review process.” Public participation, from a bureaucratic perspective, can assist uncertain and interdependent task implementations. Results from FDA drug committees suggest they meet both the quality and legitimacy expectations of participatory bureaucracy. Drugs submitted to the FDA for review between 1989 and 2000 that went to an advisory committee for review before approval were significantly less likely to encounter post-marketing problems – subsequent boxed warnings and withdrawals from the market – than drugs that did not receive an advisory committee review, all else being equal. Moreover, results also suggest that, in this time period, drugs that received advisory committee reviews were less likely to be part of subsequent General Accounting Office reviews. These findings are an astonishing testament to the promise of participatory bureaucracy, given that Chapter 6 reveals that the FDA sends its most challenging drugs to committees for review, given allegations that firms corrupt the advisory process, and given periodic charges that committee reviews are perfunctory. When participatory bureaucracy works, evidence suggests it can make uncertain and interdependent implementations better, supporting bureaucratic administration and possibly democratic accountability as well.