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Toward a procedure for integrating moral issues in health technology assessment

  • Bjørn Hofmann (a1)


Objectives: Although ethics has been on the agenda in health technology assessment (HTA) since its inception, the integration of moral issues is still not standard and is performed in a vast variety of ways. Therefore, there is a need for a procedure for integrating moral issues in HTA.

Methods: Literature review of existing approaches together with application of various theories in moral philosophy and axiology.

Results: The article develops a set of questions that addresses a wide range of moral issues related to the assessment and implementation of health technology. The issues include general moral issues and moral issues related to stakeholders, methodology, characteristics of technology, and to the HTA process itself. The questions form a kind of checklist for use in HTAs.

Conclusions: The presented approach for integrating moral issues in HTA has a broad theoretical foundation and has shown to be useful in practice. Integrating ethical issues in HTAs can be of great importance with respect to the dissemination of HTA results and in efficient health policy making.



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Beauchamp TL, Childress JF. 2001. Principles of biomedical ethics. New York: Oxford University Press;
Beecher HK. 1955 The powerful placebo. JAMA. 159: 16021606.
Blume SS. 1992. Insight and Industry. On the Dynamics of Technological Change in Medicine. Cambridge Mass: The MIT Press;
Calman KC. 1994 The ethics of allocation of scarce health care resources: a view from the centre. J Med Ethics. 20: 7174.
Caplan AL. 1983. How should values count in the allocation of new technologies in health care? In: Bayer R, Caplan AL, Daniels N, eds. Search of equity. New York: Plenum Press;
Clausen C, Yoshinaka Y. 2004 Social shaping of technology in TA and HTA. Poiesis Prax. 2: 221246.
Fischer ES, Welch HG. 1999 Avoiding the unintended consequences of growth in medical care. JAMA. 281: 446453.
Grunwald A. 2004 The normative basis of (health) technology assessment and the role of ethical expertise. Poiesis Prax. 2: 175193.
Heitman E. 1998 Ethical issues in technology assessment. Conceptual categories and procedural considerations. Int J Technol Assess Health Care. 14: 544566.
Hennen L. 2004 Biomedical and bioethical issues in parliamentary TA and in health technology assessment. Poiesis Prax. 2: 207220.
Hofmann B. 2002 Is there a technological imperative in health care? Int J Technol Assess Health Care. 18: 675689.
Hofmann B. 2003 Technology assessment of intracytoplasmic sperm injection (ICSI)—An analysis of the value context. Fertil Steril. 80: 930935.
Hofmann B. 2002. The technological invention of disease—on disease, technology and values. Thesis. Oslo: University of Oslo;
Ingerslev HJ, Poulsen PB, Højgaard A, et al. Præimplantationsdiagnostik: En medicinsk teknologivurdering. Copenhagen: Center for evaluering og medicinsk teknologivurdering; 2002 7779.
Jonsson E, Banta HD, Henshall C, Sampietro-Colom L. 2002 Summary report of the ECHTA/ECAHI project. Int J Technol Assess Health Care. 18: 218237.
Marwick C. 1988 Philosophy on trial: Examining ethics of clinical investigation. JAMA. 260: 749751.
Reuzel R, Oortwijn W, Decker M, et al. 2004 Ethics and HTA: some lessons and challenges for the future. Poiesis Prax. 2: 247256.
Reuzel RP, van der Wilt GJ, ten Have HA, de Vries Robbe PF. 1999 Reducing normative bias in health technology assessment: interactive evaluation and casuistry. Med Health Care Philos. 2: 255263.
Rothman DJ. 1997. Beginnings count: The technological imperative in American health care. New York: Oxford University Press;
Skorupinski B, Ott K. 2002 Technology assessment and ethics. Poiesis and Praxis. 1: 95122.
Solbakk JH. 2004 Use and abuse of empirical knowledge in contemporary bioethics. A critical analysis of empirical arguments employed in the controversy surrounding studies of maternal-fetal HIV-transmission and HIV-prevention in developing countries. Med Health Care Philos. 7: 516.
ten Have HA. 1995 Medical technology assessment and ethics. Ambivalent relations. Hastings Cent Rep. 25: 1319.
Van der Wilt GJ, Reuzel R, Banta HD. 2000 The ethics of assessing health technologies. Theor Med Bioeth. 21: 103115.
Weingarten MA, Paul M, Leibovici L. 2004 Assessing ethics of trials in systematic reviews. BMJ. 328: 10131014.


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Toward a procedure for integrating moral issues in health technology assessment

  • Bjørn Hofmann (a1)


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