Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-19T05:46:38.973Z Has data issue: false hasContentIssue false
  • English
  • Français

INTEGRATING ETHICS IN HEALTH TECHNOLOGY ASSESSMENT: MANY WAYS TO ROME

Part of: Special Collection - Methods

Published online by Cambridge University Press:  11 June 2015

Björn Hofmann ,
Wija Oortwijn ,
Kristin Bakke Lysdahl ,
Pietro Refolo ,
Dario Sacchini ,
Gert Jan van der Wilt  and
Ansgar Gerhardus
Björn Hofmann
Affiliation:
Centre for Medical Ethics, University of Oslo and University College of Gjø[email protected]
Wija Oortwijn
Affiliation:
ECORYS Netherlands BV
Kristin Bakke Lysdahl
Affiliation:
Centre for Medical Ethics, University of Oslo
Pietro Refolo
Affiliation:
Institute of Bioethics, “A. Gemelli” School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
Dario Sacchini
Affiliation:
Institute of Bioethics, “A. Gemelli” School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
Gert Jan van der Wilt
Affiliation:
Radboud University Medical Centre, Institute for Health Sciences, Nijmegen, the Netherlands
Ansgar Gerhardus
Affiliation:
Institute of Public Health and Nursing Research, University of Bremen, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The aim of this study was to identify and discuss appropriate approaches to integrate ethical inquiry in health technology assessment (HTA).

Methods: The key question is how ethics can be integrated in HTA. This is addressed in two steps: by investigating what it means to integrate ethics in HTA, and by assessing how suitable the various methods in ethics are to be integrated in HTA according to these meanings of integration.

Results: In the first step, we found that integrating ethics can mean that ethics is (a) subsumed under or (b) combined with other parts of the HTA process; that it can be (c) coordinated with other parts; or that (d) ethics actively interacts and changes other parts of the HTA process. For the second step, we found that the various methods in ethics have different merits with respect to the four conceptions of integration in HTA.

Conclusions: Traditional approaches in moral philosophy tend to be most suited to be subsumed or combined, while processual approaches being close to the HTA or implementation process appear to be most suited to coordinated and interactive types of integration. The article provides a guide for choosing the ethics approach that appears most appropriate for the goals and process of a particular HTA.

Keywords

EthicsValuesMoralsNormsHealth Technology Assessment
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 31 , Issue 3 , 2015 , pp. 131 - 137
Copyright
Copyright © Cambridge University Press 2015 

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. Banta, HD. Foreword. Poiesis Prax. 2004;2:93–95.Google Scholar
2. Banta, HD, Perry, S. A history of ISTAHC. A personal perspective on its first 10 years. International Society of Technology Assessment in Health Care. Int J Technol Assess Health Care. 1997;13:430–453; discussion 54-62.Google Scholar
3. Office of Technology Assessment (OTA). Development of medical technologies: Opportunities for assessment. Washington, DC: United States Congress; 1976.Google Scholar
4. Liberati, A, Sheldon, TA, Banta, HD. EUR-ASSES Project Subgroup. Report on methodology: Methodological guidance for the conduct of health technology assessment. Int J Technol Assess Health Care. 1997;13:186–219.CrossRefGoogle ScholarPubMed
5. Jonsson, E, Banta, HD, Henshall, C, et al. Summary report of the ECHTA/ECAHI project. European Collaboration for Health Technology Assessment/Assessment of Health Interventions. Int J Technol Assess Health Care. 2002;18:218–237.Google Scholar
6. International Network of Agencies for Health Technology Assessment. Technology assessment. Alberta, Canada: HTA Resources: International Network of Agencies for Health Technology Assessment; 2011.Google Scholar
7. Burls, A, Caron, L, Cleret de Langavant, G, et al. Tackling ethical issues in health technology assessment: A proposed framework. Int J Technol Assess Health Care. 2011;27:230–237. doi: 10.1017/S0266462311000250.Google Scholar
8. Saarni, SI, Braunack-Mayer, A, Hofmann, B, et al. Different methods for ethical analysis in health technology assessment: An empirical study. Int J Technol Assess Health Care. 2011;27(4):305–312. doi: 10.1017/S0266462311000444.CrossRefGoogle ScholarPubMed
9. Droste, S, Dintsios, C-M, Gerber, A, et al. Integrating ethical issues in HTAs: More methods than applications? 7th Annual Meeting HTAi RDS Conference Center Dublin, Ireland, 2010.Google Scholar
10. Hofmann, BM. Why ethics should be part of health technology assessment. Int J Technol Assess Health Care. 2008;24:423–429. doi: 10.1017/S0266462308080550.Google Scholar
11. Lavis, J, Wilson, M, Grimshaw, J, et al. Towards optimally packaged and relevance assessed health technology assessments. Report Submitted to the Canadian Agency for Drugs and Technologies in Healthcare. Hamilton, Ontario: McMaster University Program in Policy Decision-Making; 2007.Google Scholar
12. DeJean, D, Giacomini, M, Schwartz, L, et al. Ethics in Canadian health technology assessment: A descriptive review. Int J Technol Assess Health Care. 2009;25:463–469. doi: 10.1017/s0266462309990390.Google Scholar
13. Assasi, N, Schwartz, L, Tarride, JE, et al. Methodological guidance documents for evaluation of ethical considerations in health technology assessment: A systematic review. Exp Rev Pharmacoecon Outcomes Res. 2014;14:203–220. doi: 10.1586/14737167.2014. 894464.Google Scholar
14. ten Have, H. Ethical perspectives on health technology assessment. Int J Technol Assess Health Care. 2004;20:71–76.Google Scholar
15. Hofmann, B. Ethical challenges with welfare technology: A review of the literature. Sci Eng Ethics. 2013;19:389–406. doi: 10.1007/s11948-011-9348-1.CrossRefGoogle ScholarPubMed
16. Zon, M. Nederlandse organisatie voor gezondheidsonderzoek en zorginnovatie. Informatiebrochure DoelmatigheidsOnderzoek. Subsidieronde. 2012. Den Haag, 2010. Available via: http://www.zonmw.nl/uploads/tx_vipublicaties/Brochure_2012_binnenwerk.pdf (accessed January 22, 2015).Google Scholar
17. Hofmann, B. Ethical aspects of bariatric treatment of adult obesity. Alberta, Canada: Institute of Health Economics; 2011.Google Scholar
18. Kheiraoui, F, de Waure, C, Specchia, M, et al. The 13-valent pneumococcal conjugated vaccine introduction in subjects aged >50 years: The result of a Health Technology Assessment: Flavia Kheiraoui. Eur J Public Health. 2013;23(Suppl 1). doi: 10.1093/eurpub/ckt124.117.CrossRefGoogle Scholar
19. Reuzel, RP, van der Wilt, GJ, HA, ten Have, et al. Reducing normative bias in health technology assessment: Interactive evaluation and casuistry. Med Health Care Philos. 1999;2:255–263.Google Scholar
20. Reuzel, RP, van der Wilt, GJ, ten Have, HA, et al. Interactive technology assessment and wide reflective equilibrium. J Med Philos. 2001;26:245–261. doi: 10.1076/jmep.26.3.245.3015.Google Scholar
21. Lampe, K, Makela, M, Garrido, MV, et al. The HTA core model: A novel method for producing and reporting health technology assessments. Int J Technol Assess Health Care. 2009;25(Suppl 2):9–20. doi: 10.1017/S0266462309990638.Google Scholar
22. 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
23. Hofmann, B, Droste, S, Oortwijn, W, et al. Harmonization of ethics in health technology assessment: A revision of the Socratic approach. Int J Technol Assess Health Care. 2014;30:3–9. doi: 10.1017/ S0266462313000688.Google Scholar
24. Petticrew, M, Anderson, L, R, Elder, et al. Complex interventions and their implications for systematic reviews: A pragmatic approach. J Clin Epidemiol. 2013;66:1209–1214. doi: 10.1016/j.jclinepi.2013.06.004.Google Scholar
Supplementary material: File

Hofmann supplementary material

Hofmann supplementary material 1

Download Hofmann supplementary material(File)
File 214 KB