Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-31T22:56:03.140Z Has data issue: false hasContentIssue false
  • English
  • Français

Ethics and health technology assessment: Handmaiden and/or critic?

Published online by Cambridge University Press:  09 August 2006

Annette J. Braunack-Mayer
Annette J. Braunack-Mayer
Affiliation:
University of Adelaide
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: This study examines the content and role of ethical analysis in health technology assessment (HTA) and horizon scanning publications. It proposes that ethical analysis in HTA is of at least two different types: an ethics of HTA and an ethics in HTA.

Methods: I examine the critical differences between these approaches through the examples of the analysis of genetic screening for breast cancer and home blood glucose testing in diabetes. I then argue that, although both approaches subscribe to similar views concerning HTA and ethics, they use different theoretical and methodological traditions to interpret and explain them.

Results and Conclusions: I conclude by suggesting that we need the interpretive insights of both these approaches, taken together, to explain why ethics has not been able yet to contribute fully to HTA and to demonstrate the scope and complexity of ethical work in this domain.

Keywords

EthicsSocial analysisProcedureScience and technology study
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 3 , July 2006 , pp. 307 - 312
Copyright
© 2006 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

Ashcroft RE. Health technology assessment. The concise encyclopedia of the ethics of new technologies. San Diego: Academic Press; 2001: 235– 244.
Banta HD. 2004 Foreword. Poeisis Praxis. 2: 93– 95.Google Scholar
Beauchamp TL, Childress JF. 2001. Principles of biomedical ethics. 5th ed. New York: Oxford University Press;
Coster S, Gulliford M, Seed P, Powrie J, Swaminathan R. 2000 Monitoring blood glucose control in diabetes mellitus: A systematic review. Health Technol Assess. 4: i– iv, 1– 93.Google Scholar
Decker M. 2004 The role of ethics in interdisciplinary technology assessment. Poiesis Praxis. 2: 139– 156.Google Scholar
Fox RC. 1994: The entry of U.S. bioethics into the 1990s: A sociological account. In: DuBose E, Hamel R, O'Connell L, eds. A matter of principles? Ferment in U.S. bioethics. Valley Forge, PA: Trinity Press International; 21– 71.
Freidson E. 1970. Professional dominance. Palo Alto, CA: Atherton Press;
Gallo P. 2004 Integrating ethical enquiry and health technology assessment: Limits and opportunities for efficiency and equity. Poiesis Praxis. 2: 103– 117.Google Scholar
Gillon R. 1994 Medical ethics: Four principles plus attention to scope. BMJ. 309: 184– 188.Google Scholar
Grieve R, Beech R, Vincent J, Mazurkiewicz J. 1999 Near patient testing in diabetes clinics: Appraising the costs and outcomes. Health Technol Assess. 3: 1– 74.Google Scholar
Grunwald A. 2004 The normative basis of (health) technology assessment and the role of ethical expertise. Poeisis Praxis. 2: 175– 193.Google Scholar
Hennen L. 2004 Biomedical and bioethical issues in parliamentary TA and in health technology assessment. Poiesis Praxis. 2: 207– 220.Google Scholar
Kaebnick G. 2000 On the intersection of casuistry and particularism. Kennedy Inst Ethics J 10: 307– 322.Google Scholar
Mol A. 2000 What diagnostic devices do: The case of blood sugar measurement. Theor Med Bioeth. 21: 9– 22.Google Scholar
Muir Gray J. 2001. Evidence-based healthcare. How to make health policy and management decisions. London: Churchill Livingstone;
Noorani H, McGahan L. 1999. Predictive genetic testing for breast and prostate cancer. Ottawa: Canadian Coordinating Office for Health Technology Assessment (CCOHTA);
Oortwjin W, Reuzel R, Decker M. 2004 Introduction. Poiesis Praxis. 2: 97– 101.Google Scholar
Parker LS. 1995 Breast cancer genetic screening and critical bioethics' gaze. J Med Philos. 20: 313– 337.Google Scholar
Perry S, Gardner E, Thamer M. 1997 The status of health technology assessment worldwide: Results of an international survey. Int J Technol Assess Health Care. 13: 81– 94.Google Scholar
Reuzel R, Oortwijn W, Decker M, et al. 2004 Ethics and HTA: Some lessons and challenges for the future. Poeisis Praxis. 2: 247– 256.Google Scholar
Reynolds C. 1995. Public health law in Australia. Leichhardt, NSW: Federation Press;
Robinson EJ, Kerr CE, Stevens AJ, et al. 2005 Lay public's understanding of equipoise and randomisation in randomised controlled trials. Health Technol Assess. 9: iii– iv, 1– 192.Google Scholar
Seay G. 2002 Theory skepticism and moral dilemmas. Kennedy Inst Ethics J. 12: 279– 298.Google Scholar
ten Have H. 2004 Ethical perspectives on health technology assessment. Int J Technol Assess Health Care. 20: 71– 76.Google Scholar
ten Have H. 1995 Medical technology assessment and ethics: Ambivalent relations. Hastings Cent Rep. 25: 13– 19.Google Scholar
van der Wilt GJ. 2004 Health technology assessment: Trying to bring empirical and ethical inquiry together. Poiesis Praxis. 2: 195– 206.Google Scholar
Vieth A. 1999 The revival of casuistry in applied ethics and its problems. Med Health Care Philos. 2: 51– 53.Google Scholar
Vos R, Willems DL. 2000 Technology in medicine: Ontology, epistemology, ethics and social philosophy at the crossroads. Theor Med Bioeth. 21: 1– 7.Google Scholar
Wildes KW. 2001 The crisis of medicine: Philosophy and the social construction of medicine. Kennedy Inst Ethics J. 11: 71– 86.Google Scholar