Conclusion

Through the exploration of these cases across Brazil, the US, and Mexico, a shared need emerges for more equitable relationships between institutions and individuals. As a byproduct of today’s globalized society, institutions have become removed from the people with whom they interact. In Brazil, the lack of equitable access between the internet and the average citizen jeopardizes its effectiveness at encouraging participation. In the US, unequal relationships between doctors and patients are putting patients at risk of maltreatment and preventing institutional accountability. Similarly in Mexico, the inequitable relationship between indigenous communities, the Mexican government, and international corporations has further plunged native peoples across the country into poverty. While strides are being made in each case to help empower citizens to repair and improve the wellbeing of those concerned, at the core of each is the need for better relationships between various institutions and the people they affect.

In the first chapter we discovered that while the internet is an exciting new method of communication, unequal access limits its effectiveness in encouraging empowered citizen participation. Accordingly, including the internet in strategies to improve participation is not as effective as employing traditional methods. However, if internet access were to improve, then its usage could aid in encouraging and empowering average citizens worldwide. To accomplish this, there must be equitable access across both regions and demographics. Moreover, organizations such as Nossas that use the internet as part of their tactics to empower and encourage participation will find more success in their virtual methods. Therefore while the internet today is not effective in encouraging participation due to disparities in access, improvements could transform it into a great empowering force for citizen participation.

In the second chapter, we discussed a citizen participation model that is emerging in the highly private sphere of medicine. While the institution is steeped in power imbalances and inequity, from its racist history to the traditional paternalistic physician-patient relationship, the participation model of shared decision-making aims to become a clinical best practice and reorient power dynamics towards mutualism. While a promising and critical first step towards inserting democratic processes into the growing industry, several gaps remain between the current state of the model and its full implementation. We have demonstrated that citizen participation models require the adequate space and resources to be successful, and this will be especially important in this case, as citizens do not expect to participate in this traditionally paternalistic institution. Thus, its ongoing implementation will hinge on physician transparency and rigorous results-oriented research to understand the direct impact of the model and foster accountability.

In the last chapter, we examined the Zapatista rebellion and the autonomous municipalities they have established over the past few decades. Although the demands of the 1994 rebellion were not amended by the Mexican government, the Zapatista Army of National Liberation successfully interfered with the imperial core of capitalism by utilizing tactics that predate and exist outside of the Western colonial framework. However, as native communities around the world continue to struggle for their land and rights to self-determination, the very concepts which dominate our social and political institutions, like private ownership and bureaucracy, invalidate indigenous cultural attitudes. If indigenous rights are to be restored and respected, traditional notions of power as supremacy and individualist attitudes toward social relations must be dissolved. Like the Zapatistas, the masses must abandon governmental reform as the means for promoting justice and instead look toward bottom-up methods of enacting social change.

In these cases, grassroots mobilization has been used to empower citizens to have greater autonomy within the institution-individual relationship, but the participation models also highlight spaces where the impact of their efforts could be enhanced. In Brazil, strides were taken to improve citizen participation through internet strategies. In the US, shared decision-making is leading to improved patient care and greater patient autonomy in physician-patient relationships. Lastly, in Mexico, the Zapatistas mobilized to protect indigenous autonomy and rights to the land. The contextually specific continuation and expansion of these efforts depend on more equitable relationships between institutions, such as the internet, medicine, and the state, and the people they concern. Thus, as globalization continues to increasingly disconnect citizens from these institutions, the need for empowering citizen participation is as dire as ever before.