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Ethical evaluation in health technology assessment reports: An eclectic approach

Published online by Cambridge University Press:  18 January 2007

Ilona Autti-Rämö  and
Marjukka Mäkelä
Ilona Autti-Rämö
Affiliation:
University of Helsinkiand STAKES
Marjukka Mäkelä
Affiliation:
University of Copenhagenand STAKES
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Abstract

Objectives: Ethical evaluation has become an important part of health technology assessment (HTA), but so far no generally accepted method for doing this exists. This article explains the eclectic approach developed at the Finnish HTA office.

Methods: Each HTA report is produced in cooperation with the methodological and clinical experts from various levels of healthcare organizations. An open framework for ethical evaluation when assessing different types of interventions is used to identify all possible stakeholders for each particular intervention. The ethical consequences for each party are identified during the entire process of the HTA project.

Results: The results of an ethical evaluation in four different HTA projects (two on screening, one on surgical intervention, and one in rehabilitation) show that an open framework is useful for opening discussion and understanding the scope of each ethical evaluation. Both content and methodological experts have found the process to be useful in capturing the broad consequences of implementing a new method.

Conclusions: Ethical evaluation is a continuous process that considers the prevalent morals, values, and behavioral models of the society. An in-depth ethical evaluation helps the decision-makers to realize the consequences that implementing a new method has on individual citizens, the healthcare system, and society.

Keywords

Ethical evaluationHTA
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 23 , Issue 1 , January 2007 , pp. 1 - 8
Copyright
© 2007 Cambridge University Press

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References

Autti-Rämö I, Laajalahti L, Koskinen H, Sintonen H, Mäkelä M, and expert group.Screening for rare metabolic disease in newborn infants. 2005. FinOHTA report 22/2004. Available at: http://www.stakes.fi/finohta/.Google Scholar
Autti-Rämö I, Mäkelä M, Sintonen H, et al. 2005 Expanding screening for rare metabolic disease in the newborn: An analysis of costs, effect and ethical consequences for decision making in Finland. Acta Paediatr. 94: 1126– 1136.Google Scholar
Autti-Rämö I, Koskinen H, Mäkelä M, Ritvanen A, Taipale P, and working group. 2005. Maternal ultrasound and serum screening in the detection of structural and chromosomal abnormalities. Finohta report 27/2005. Available at: http://www.stakes.fi/finohta/.Google Scholar
Beauchamp T, Childress J. 2001. Principles of biomedical ethics. New York: Oxford University Press.
Butler C, Darrah J. 2001 AACPDM evidence report: Effects of neurodevelopmental treatment (NDT) for cerebral Palsy. Dev Med Child Neurol. 43: 778– 790.Google Scholar
EUR-ASSESS. 1997 Introduction to the EUR-Assess Project. Int J Technol Assess Health Care. 13: 133– 143.
GRADE Working group. 2004 Grading quality of evidence and strength of recommendations. Br Med J. 328: 1490– 1449.Google Scholar
Hailey D. Juzwishin D. 2005. Risk management for health technology assessment programs. AHFMR, HTA Initiative # 19. Available at: http://www.ahfmr.ab.ca/hta/.Google Scholar
Health Council of the Netherlands. 2005. Neonatal screening. The Hague: Health Council of the Neatherland, Publication no. 2005/11. Available at: http://www.gr.nl/.
Hofmann B. 2005; On value-judgements and ethics in health technology assessment. Poiesis Prax. 277– 295.Google Scholar
Hofmann B. 2005 Toward a procedure for integrating moral issues in health technology assessment. Int J Technol Assess Health Care. 21: 312– 318.Google Scholar
Malmivaara A, Kuukasjärvi P, Mäkelä M, and working group. 2005. Effectiveness of invasive treatment for coronary artery disease. Overview of systematic reviews. Finohta report 25/2005. Available at: http://www.stakes.fi/finohta/.Google Scholar
Santalahti P, Aro AR, Hemminki E, Helenius H, Ryynänen M. 1998 On what grounds do women participate in prenatal screening? Prenat Diagn. 18: 153– 165.Google Scholar
Santalahti P, Hemminki E, Aro AR, Helenius H, Ryynänen M. 1999 Participation in prenatal screening tests and intentions concerning selective termination in Finnish maternity care. Fetal Diagn Ther. 14: 71– 79.Google Scholar
Visakorpi JK, Palo J, Renkonen O-V. 1971 The incidence of PKU in Finland. Acta Paediatr Scand. 60: 666– 668.Google Scholar