Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T06:01:39.806Z Has data issue: false hasContentIssue false
  • English
  • Français

HARMONIZATION OF ETHICS IN HEALTH TECHNOLOGY ASSESSMENT: A REVISION OF THE SOCRATIC APPROACH

Part of: Special Collection - Methods

Published online by Cambridge University Press:  05 February 2014

Bjørn Hofmann ,
Sigrid Droste ,
Wija Oortwijn ,
Irina Cleemput  and
Dario Sacchini
Bjørn Hofmann
Affiliation:
University College of Gjøvik and University of Oslo
Sigrid Droste
Affiliation:
IQWiG, Germany
Wija Oortwijn
Affiliation:
ECORYS Netherlands BV
Irina Cleemput
Affiliation:
Hasselt University and KCE, Belgium
Dario Sacchini
Affiliation:
Institute of Bioethics, “Agostino Gemelli” School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Ethics has been part of health technology assessment (HTA) from its beginning in the 1970s, and is currently part of HTA definitions. Several methods in ethics have been used in HTA. Some approaches have been developed especially for HTA, such as the Socratic approach, which has been used for a wide range of health technologies. The Socratic approach is used in several ways, and there is a need for harmonization to promote its usability and the transferability of its results. Accordingly, the objective of this study was to stimulate experts in ethics and HTA to revise the Socratic approach.

Methods: Based on the current literature and experiences in applying methods in ethics, a panel of ethics experts involved in HTA critically analyzed the limitations of the Socratic approach during a face-to-face workshop. On the basis of this analysis a revision of the Socratic approach was agreed on after deliberation in several rounds through e-mail correspondence.

Results: Several limitations with the Socratic approach are identified and addressed in the revised version which consists of a procedure of six steps, 7 main questions and thirty-three explanatory and guiding questions. The revised approach has a broader scope and provides more guidance than its predecessor. Methods for information retrieval have been elaborated.

Conclusion: The presented revision of the Socratic approach is the result of a joint effort of experts in the field of ethics and HTA. Consensus is reached in the expert panel on an approach that is considered to be more clear, comprehensive, and applicable for addressing ethical issues in HTA.

Keywords

EthicsMoralValuesNormsHealth technology assessment
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 30 , Issue 1 , January 2014 , pp. 3 - 9
Copyright
Copyright © Cambridge University Press 2014 

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

REFERENCES

1. Office of Technology Assessment. Development of medical technology: Opportunities for assessment. Washington, DC: Office of Technology Assessment; 1976.Google Scholar
2. Burls, A, Caron, L, Langavant, GC, et al. Tackling ethical issues in health technology assessment: A proposed framework. Int J Technol Assess Health Care. 2011;27:230–237.Google Scholar
3. Droste, S, Dintsios, CM, Gerber, A, Rüther, A. Integrating ethical issues in HTAs: More methods than applications? In: HTAi 7th Annual Meeting Dublin 2010. Maximizing the value of HTA. Book of Abstracts; Dublin: 2010;M5-02:169.Google Scholar
4. Hofmann, B. Toward a procedure for integrating moral issues in health technology assessment. Int J Technol Assess Health Care. 2005;21:312–318.Google Scholar
5. Saarni, S, Braunack-Mayer, A, Hofmann, B, van der Wilt, GJ. Different methods for ethical analysis in health technology assessment: An empirical study. Int J Technol Assess Health Care. 2011;27:305–312.Google Scholar
6. Saarni, SI, Hofmann, B, Lampe, K, et al. Ethical analysis to improve decision-making on health technologies. Bull World Health Organ. 2008;86:617–623.Google Scholar
7. DeJean, D, Giacomini, M, Schwartz, L, Miller, FA. Ethics in Canadian health technology assessment: A descriptive review. Int J Technol Assess Health Care. 2009;25:463–469.Google Scholar
8. Droste, S, Gerhardus, A, Kollek, R. [Methods for the assessment of ethical aspects and moral concepts in society in short HTA reports an international survey]. Niebüll: Medicombooks; 2003.Google Scholar
9. Hofmann, B. Why ethics should be part of health technology assessment. Int J Technol Assess Health Care. 2008;24:423–429.Google Scholar
10. Lehoux, P, Williams-Jones, B. Mapping the integration of social and ethical issues in health technology assessment. Int J Technol Assess Health Care. 2007;23:9–16.Google Scholar
11. Ten Have, H. Ethical perspectives on health technology assessment. Int J Technol Assess Health Care. 2004;20:71–76.Google Scholar
12. Hofmann, B. On value-judgements and ethics in health technology assessment. Poiesis Prax. 2005;3:277–295.Google Scholar
13. Brinch, B, Husebekk, A, Funderud, S, Lyngstadaas, A. Therapeutic use of haematopoietic stem cells from cord blood. Oslo: SMM-rapport No. 4/2003.Google Scholar
14. Droste, S, Herrmann-Frank, A, Scheibler, F, Krones, T. Ethical issues in autologous stem cell transplantation (ASCT) in advanced breast cancer: A systematic literature review. BMC Med Ethics. 2011;12:6.Google Scholar
15. UK National Screening Committee [Internet]. London: Criteria for appraising the viability, effectiveness and appropriateness of a screening programme [cited 2012 Aug 12]. http://www.screening.nhs.uk/criteria (Accessed, July 1, 2012).Google Scholar
16. Hofmann, B. Etikk i vurdering av helsetiltak [Ethics in Health Technology Assessments (HTA)] Oslo: Norwegian Knowledge Centre for the Health Services; 2008.Google Scholar
17. Centre for Reviews and Dissemination. Systematic reviews: CRD's guidance for undertaking reviews in health care. York: CRD, University of York; 2009.Google Scholar
18. McCullough, LB, Coverdale, JH, Chervenak, FA. Constructing a systematic review for argument-based clinical ethics literature: The example of concealed medications. J Med Philos. 2007;32:65–76.Google Scholar
19. Sofaer, N, Strech, D. The need for systematic reviews of reasons. Bioethics. 2012;26:315–328.Google Scholar
20. Strech, D, Sofaer, N. How to write a systematic review of reasons. J Med Ethics. 2012;38:121–126.Google Scholar
21. Hannes, K, Lockwood, C, Pearson, A. A comparative analysis of three online appraisal instruments’ ability to assess validity in qualitative research. Qual Health Res. 2010;20:1736–1743.Google Scholar
22. Oortwijn, WJ. First things first: Priority setting for Health Technology Assessment [Dissertation]. Leiden: De Bink BV; 2000.Google Scholar
23. Ministerie, VWS. Acht nieuwe geneesmiddelen toegelaten tot het ziekenfondspakket (12 April 2000, nr. 38). Den Haag: Ministerie van Volksgezondheid, Welzijn en Sport; 2000.Google Scholar
24. Stolk, EA, Brouwer WBF, Busschbach JJV. Vergoeding van Viagra stuit op waarden en normen. Medisch Contact. [Internet]. 2002 May [cited 2012 July 7]; 55(17):. http://medischcontact.artsennet.nl/Nieuws-26/archief-6/Tijdschriftartikel/05670/Vergoeding-van-Viagra-stuit-op-waarden-en-normen.htm (accessed, July 1, 2012)Google Scholar
25. Daniels, N, Sabin, J. Limits to health care: Fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philos Public Aff. 1997;26:303–350.Google Scholar
Supplementary material: File

Hofmann Supplementary Material

Supplementary Material

Download Hofmann Supplementary Material(File)
File 39.7 KB