Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-19T02:19:10.007Z Has data issue: false hasContentIssue false
  • English
  • Français

Toward a procedure for integrating moral issues in health technology assessment

Published online by Cambridge University Press:  04 August 2005

Bjørn Hofmann
Bjørn Hofmann
Affiliation:
University of Oslo and The Norwegian Health Services Research Centre
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Although ethics has been on the agenda in health technology assessment (HTA) since its inception, the integration of moral issues is still not standard and is performed in a vast variety of ways. Therefore, there is a need for a procedure for integrating moral issues in HTA.

Methods: Literature review of existing approaches together with application of various theories in moral philosophy and axiology.

Results: The article develops a set of questions that addresses a wide range of moral issues related to the assessment and implementation of health technology. The issues include general moral issues and moral issues related to stakeholders, methodology, characteristics of technology, and to the HTA process itself. The questions form a kind of checklist for use in HTAs.

Conclusions: The presented approach for integrating moral issues in HTA has a broad theoretical foundation and has shown to be useful in practice. Integrating ethical issues in HTAs can be of great importance with respect to the dissemination of HTA results and in efficient health policy making.

Keywords

EthicsProcedureMoralScience and technology studies
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 3 , July 2005 , pp. 312 - 318
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beauchamp TL, Childress JF. 2001. Principles of biomedical ethics. New York: Oxford University Press;
Beecher HK. 1955 The powerful placebo. JAMA. 159: 1602– 1606.Google Scholar
Blume SS. 1992. Insight and Industry. On the Dynamics of Technological Change in Medicine. Cambridge Mass: The MIT Press;
Calman KC. 1994 The ethics of allocation of scarce health care resources: a view from the centre. J Med Ethics. 20: 71– 74.Google Scholar
Caplan AL. 1983. How should values count in the allocation of new technologies in health care? In: Bayer R, Caplan AL, Daniels N, eds. Search of equity. New York: Plenum Press;
Clausen C, Yoshinaka Y. 2004 Social shaping of technology in TA and HTA. Poiesis Prax. 2: 221– 246.Google Scholar
Fischer ES, Welch HG. 1999 Avoiding the unintended consequences of growth in medical care. JAMA. 281: 446– 453.Google Scholar
Grunwald A. 2004 The normative basis of (health) technology assessment and the role of ethical expertise. Poiesis Prax. 2: 175– 193.Google Scholar
Heitman E. 1998 Ethical issues in technology assessment. Conceptual categories and procedural considerations. Int J Technol Assess Health Care. 14: 544– 566.Google Scholar
Hennen L. 2004 Biomedical and bioethical issues in parliamentary TA and in health technology assessment. Poiesis Prax. 2: 207– 220.Google Scholar
Hofmann B. 2002 Is there a technological imperative in health care? Int J Technol Assess Health Care. 18: 675– 689.Google Scholar
Hofmann B. 2003 Technology assessment of intracytoplasmic sperm injection (ICSI)—An analysis of the value context. Fertil Steril. 80: 930– 935.Google Scholar
Hofmann B. 2002. The technological invention of disease—on disease, technology and values. Thesis. Oslo: University of Oslo;
Ingerslev HJ, Poulsen PB, Højgaard A, et al. Præimplantationsdiagnostik: En medicinsk teknologivurdering. Copenhagen: Center for evaluering og medicinsk teknologivurdering; 2002 77– 79.
Jonsson E, Banta HD, Henshall C, Sampietro-Colom L. 2002 Summary report of the ECHTA/ECAHI project. Int J Technol Assess Health Care. 18: 218– 237.Google Scholar
Marwick C. 1988 Philosophy on trial: Examining ethics of clinical investigation. JAMA. 260: 749– 751.Google Scholar
Reuzel R, Oortwijn W, Decker M, et al. 2004 Ethics and HTA: some lessons and challenges for the future. Poiesis Prax. 2: 247– 256.Google Scholar
Reuzel RP, van der Wilt GJ, ten Have HA, de Vries Robbe PF. 1999 Reducing normative bias in health technology assessment: interactive evaluation and casuistry. Med Health Care Philos. 2: 255– 263.Google Scholar
Rothman DJ. 1997. Beginnings count: The technological imperative in American health care. New York: Oxford University Press;
Skorupinski B, Ott K. 2002 Technology assessment and ethics. Poiesis and Praxis. 1: 95– 122.Google Scholar
Solbakk JH. 2004 Use and abuse of empirical knowledge in contemporary bioethics. A critical analysis of empirical arguments employed in the controversy surrounding studies of maternal-fetal HIV-transmission and HIV-prevention in developing countries. Med Health Care Philos. 7: 5– 16.Google Scholar
ten Have HA. 1995 Medical technology assessment and ethics. Ambivalent relations. Hastings Cent Rep. 25: 13– 19.Google Scholar
Van der Wilt GJ, Reuzel R, Banta HD. 2000 The ethics of assessing health technologies. Theor Med Bioeth. 21: 103– 115.Google Scholar
Weingarten MA, Paul M, Leibovici L. 2004 Assessing ethics of trials in systematic reviews. BMJ. 328: 1013– 1014.Google Scholar