Discursive Arenas and Legitimacy Overflows: Emotion and Expertise in Orphan Drug Reimbursement

We respond to calls for a greater focus on discursive arenas, their rules, and how these enable or constrain discursive legitimation. Our abductive study explores the case of a new cystic fibrosis drug, Orkambi, and the legitimation contests that surround the Irish government’s decision as to whether or not it should be paid for from the public purse. Our dataset consisted of tweets, newspaper articles, and parliamentary debate transcripts. We define a discursive arena, suggesting it is a location for micro-level discursive interactions that is bounded in time and place, observed by an audience, and underpinned by a set of rules that shape discursive positions and foundations. We identify three non-exhaustive and continuum-based characteristics of discursive arenas: one structural (how open it is), and two bases of legitimacy (whether it eclipses or evokes emotion; and whether it values lay or professional expertise). We build on this to suggest a typology of discursive arenas ranging from hot (where legitimacy commonly overflows into and out of other arenas) to cold (where such overflows are rare). We theorize a relationship between bases of legitimacy and arena type. In doing so, we focus attention on the nature of the arenas in which social issues are debated and how this affects the way that social issues travel from arena to arena. We believe that such a focus is vital in current climates where the rise of social media, the decline of the traditional media, and the challenge of echo chambers, all change the nature of democratic debate. How arenas shape and propagate or constrain such debate is vital to the design of a sustainable democratic society.