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Core competencies for ethics experts in health technology assessment

Published online by Cambridge University Press:  09 December 2020

Pietro Refolo Open the ORCID record for Pietro Refolo [Opens in a new window] ,
Kenneth Bond Open the ORCID record for Kenneth Bond [Opens in a new window] ,
Bart Bloemen Open the ORCID record for Bart Bloemen [Opens in a new window] ,
Ilona Autti-Rämö ,
Bjørn Hofmann ,
Claudia Mischke ,
Debjani Mueller Open the ORCID record for Debjani Mueller [Opens in a new window] ,
Sylvia Nabukenya Open the ORCID record for Sylvia Nabukenya [Opens in a new window] ,
Wija Oortwijn Open the ORCID record for Wija Oortwijn [Opens in a new window]  and
Lars Sandman Open the ORCID record for Lars Sandman [Opens in a new window]
...Show all authors
Pietro Refolo*
Affiliation:
Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Kenneth Bond
Affiliation:
Institute of Health Economics, Edmonton, Alberta, Canada
Bart Bloemen
Affiliation:
Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
Ilona Autti-Rämö
Affiliation:
Council for Choices in Health Care in Finland and Unit for Steering of Services, Department for Steering of Healthcare and Social Welfare, Ministry of Social affairs and Health, Finland
Bjørn Hofmann
Affiliation:
Department of Health Science, Norwegian University of Science and Technology, Gjøvik, Norway
Claudia Mischke
Affiliation:
Department of Health Care and Health Economics, Institute for Quality and Efficiency in Health Care, Cologne, Germany
Debjani Mueller
Affiliation:
Charlotte Maxeke Research Cluster, Johannesburg, South Africa
Sylvia Nabukenya
Affiliation:
Infectious Diseases Institute, Makerere University, Kampala, Uganda
Wija Oortwijn
Affiliation:
Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
Lars Sandman
Affiliation:
National Centre for Priorities in Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
Michal Stanak
Affiliation:
Austrian Institute for Health Technology Assessment, Vienna, Austria
Duncan Steele
Affiliation:
Alberta Health Services, Calgary, Canada
Gert Jan van der Wilt
Affiliation:
Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
Dario Sacchini
Affiliation:
Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
*
Author for correspondence: Pietro Refolo, E-mail: [email protected]
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Abstract

Objectives

There is no consensus on who might be qualified to conduct ethical analysis in the field of health technology assessment (HTA). Is there a specific expertise or skill set for doing this work? The aim of this article is to (i) clarify the concept of ethics expertise and, based on this, (ii) describe and specify the characteristics of ethics expertise in HTA.

Methods

Based on the current literature and experiences in conducting ethical analysis in HTA, a group of members of the Health Technology Assessment International (HTAi) Interest Group on Ethical Issues in HTA critically analyzed the collected information during two face-to-face workshops. On the basis of the analysis, working definitions of “ethics expertise” and “core competencies” of ethics experts in HTA were developed. This paper reports the output of the workshop and subsequent revisions and discussions online among the authors.

Results

Expertise in a domain consists of both explicit and tacit knowledge and is acquired by formal training and social learning. There is a ubiquitous ethical expertise shared by most people in society; nevertheless, some people acquire specialist ethical expertise. To become an ethics expert in the field of HTA, one needs to acquire general knowledge about ethical issues as well as specific knowledge of the ethical domain in HTA. The core competencies of ethics experts in HTA consist of three fundamental elements: knowledge, skills, and attitudes.

Conclusions

The competencies described here can be used by HTA agencies and others involved in HTA to call attention to and strengthen ethical analysis in HTA.

Keywords

EthicsExpertiseCompetencies
Type
Article Commentary
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 6 , December 2020 , pp. 534 - 539
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Banta, D. What is technology assessment? Int J Technol Assess Health Care. 2009;25:7–9.CrossRefGoogle ScholarPubMed
Hofmann, BM. Why ethics should be part of health technology assessment. Int J Technol Assess Health Care. 2008;24:423–9.CrossRefGoogle ScholarPubMed
European Network for Health Technology Assessment (EUnetHTA). HTA core model application for medical and surgical interventions (2.0); 2008 [cited 2017 Jul 7]; Available from: http://www.htacoremodel.info/BrowseModel.aspx.Google Scholar
Hofmann, B, et al. Revealing and acknowledging value judgments in health technology assessment. Int J Technol Assess Health Care. 2014;30:579–86.CrossRefGoogle ScholarPubMed
Hofmann, B, Bond, K, Sandman, L. Evaluating facts and facting evaluations: On the fact-value relationship in HTA. J Eval Clin Pract. 2018;24:957–65.CrossRefGoogle ScholarPubMed
Legault, GA, et al. Revisiting the fact/value dichotomy: A speech act approach to improve the integration of ethics in health technology assessment. Open J Philos. 2018;8:578–93.CrossRefGoogle Scholar
O'Rourke, B, Oortwijn, W, Schuller, T, International Joint Task Group. The new definition of health technology assessment: A milestone in international collaboration. Int J Technol Assess Health Care. 2020;36:187–90.CrossRefGoogle ScholarPubMed
Reuzel, B, van der Wilt, GJ. Technology assessment in the health care area: A matter of uncovering or of covering up? (eds. Grin, J, Grunwald, A, editors. Vision assessment: Shaping technology in 21st century society. Towards a Repertoire for Technology Assessment. Berlin: Springer-Verlag; 2000, 53–69.Google Scholar
Mueller, D, et al. Capacity building in agencies for efficient and effective health technology assessment. Int J Technol Assess Health Care. 2016;32:292–9.CrossRefGoogle ScholarPubMed
Bond, K, Oremus, M. Ethics expertise for health technology assessment: A Canadian national survey. Int J Technol Assess Health Care. 2014;30:131–6.CrossRefGoogle ScholarPubMed
Pichler, F, Oortwijn, W, Ruether, A, Trowman, R. Defining capacity building in the context of HTA: A proposal by the HTAi Scientific Development and Capacity Building Committee. Int J Technol Assess Health Care. 2019;35:362–6.CrossRefGoogle ScholarPubMed
American Society for Bioethics and the Humanities (ASBH). Core competencies for health care ethics consultation. 2nd ed.;Chicago: ASBH; 2011.Google Scholar
Collins, H, Evans, R. Rethinking expertise. Chicago: The University of Chicago Press; 2007.CrossRefGoogle Scholar
Iltis, AS, Sheehan, M. Expertise, ethics expertise, and clinical ethics consultation: Achieving terminological clarity. J Med Philos. 2016;411:416–33.CrossRefGoogle Scholar
Priaulx, N, Weinel, M, Wrigley, A. Rethinking moral expertise. Health Care Anal. 2016;24:393–406.CrossRefGoogle ScholarPubMed
Collins, H, Evans, R. The third wave of science studies: Studies of expertise and experience. Soc Stud Sci. 2002;32:235–96.CrossRefGoogle Scholar
Singer, P. Moral experts. Analysis. 1972;32:115–7.CrossRefGoogle Scholar
Noble, C. Ethics and experts. Hastings Cent Rep. 1982;12:7–15.CrossRefGoogle ScholarPubMed
Crosthwaite, J. Moral expertise: A problem in the professional ethics of professional ethicists. Bioethics. 1995;9:361–79.CrossRefGoogle ScholarPubMed
Crosthwaite, J. In defence of ethicists. A commentary on Christopher Cowley's paper. Med Health Care Philos. 2005;8:281–3.CrossRefGoogle ScholarPubMed
Cowley, C. A new rejection of moral expertise. Med Health Care Philos. 2005;8:273–9.CrossRefGoogle ScholarPubMed
Varelius, J. Is ethical expertise possible? Med Health Care Philos. 2008;11:127–32.CrossRefGoogle ScholarPubMed
Steinkamp, NL, Gordijn, B, Ten Have, HAMJ. Debating ethical expertise. Kennedy Inst Ethics J. 2008;18:173–92.CrossRefGoogle ScholarPubMed
Kovács, J. The transformation of (bio)ethics expertise in a world of ethical pluralism. J Med Ethics. 2010;36:767–70.CrossRefGoogle Scholar
Rasmussen, LM. An ethics expertise for clinical ethics consultation. J Law Med Ethics. 2011;39:649–61.CrossRefGoogle ScholarPubMed
Rasmussen, LM. Clinical ethics consultants are not “ethics” experts—But they do have expertise. J Med Philos. 2016;41:384–400.CrossRefGoogle Scholar
European Centre for the Development of Vocational Training (CEDEFOP). Typology of knowledge, skills and competences: Clarification of the concept and prototype. Luxembourg: Office for Official Publications of the European Communities; 2006.Google Scholar
Bloom, BS, Engelhart, MD, Furst, EJ, Hill, WH, Krathwohl, DR. Taxonomy of educational objectives: The classification of educational goals. Handbook I: Cognitive domain. New York: David McKay Company; 1956.Google Scholar
Gutiérrez-Ibarluzea, I, Mueller, J, Chiumente, M. Analysis of the competencies to be acquired in health technology assessment. Int J Technol Assess Health Care. 2017;33:59.Google Scholar
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