The pursuit of agreement through discussion is messy and prone to problems. Formalized consensus formation processes have been developed to address known weaknesses in how we pursue agreement. Such methods hold out hope for a way to move forward without resorting to violence or manipulation. The use of consensus formation methods is meant to ensure that the pursuit of consensus is fair and inclusive. But what is under-considered, in my view, is that the background assumptions of many consensus formation methods make these methods well-suited for some contexts but not for others. In particular, these methods may not be useful in cases of bioethical controversy for at least two reasons. First, these methods may be exclusionary. In particular, formalized methods aimed at developing consensus end up being dismissive of categories of reasons and reasoners. Each method incorporates a process for giving and receiving reasons. These processes are built in ways which assume a role of reasons at home in political liberalism, a role I want to challenge. At the very least, these assumptions should be made explicit, even if they are ultimately deemed correct and acceptable to maintain. Second, these methods falsely assume that participants are (or ought to be) idealized reasoners. More specifically, they assume participants are (or ought to be) responsive to reasons in a particular way. I will challenge this assumption and argue that, instead, being responsive to persons and not to reasons is not always problematic. Instead of using formalized consensus formation processes in bioethics, we ought to engage in the difficult, long, messy process of civil deliberation informed by the lessons which motivated the development of consensus formation processes to begin with.