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Ethics analysis of light and vitamin D therapies for seasonal affective disorder

Published online by Cambridge University Press:  04 December 2020

Michal Stanak Open the ORCID record for Michal Stanak [Opens in a new window]  and
Christoph Strohmaier
Michal Stanak*
Affiliation:
Austrian Institute for Health Technology Assessment (former Ludwig Boltzmann Institute for Health Technology Assessment), Vienna, Austria Department of Philosophy, University of Vienna, Vienna, Austria
Christoph Strohmaier
Affiliation:
Austrian Institute for Health Technology Assessment (former Ludwig Boltzmann Institute for Health Technology Assessment), Vienna, Austria
*
Author for correspondence: Michal Stanak, E-mail: michal.stanak@protonmail.com
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Abstract

Objective

The aim of this ethics analysis was to highlight the overt and covert value issues with regard to two health technologies (light therapy and vitamin D therapy), the health technology assessment (HTA) and the disease of seasonal affective disorder (SAD). The present ethics analysis served as a chapter of a full HTA report that aimed to assist decision makers concerning the two technologies.

Method

First, we used the revised Socratic approach of Hofmann et al. to build overarching topics of ethical issues, and then, we conducted a hand search and a comprehensive systematic literature search on between 12 and 14 February 2019 in seven databases.

Results

The concrete ethical issues found concerned vulnerability of the target population and the imperative to treat depressive symptoms for the sake of preventing future harm. Further disease-related ethical issues concerned the questionable nature of SAD as a disease, autonomy, authenticity, and capacity for decision making of SAD patients, and the potential stigma related to the underdiagnosis of SAD, which is contrasted with the concern over unnecessary medicalization. Regarding the interventions and comparators, the ethical issues found concerned their benefit-harm ratios and the question of social inequality. The ethical issues related to the assessment process relate to the choice of comparators and the input data for the selected health economic studies.

Conclusions

The concrete ethical issues related to the interventions, the disease, and the assessment process itself were made overt in this ethics analysis. The ethics analysis provided an (additional) value context for making future decisions regarding light and vitamin D therapies.

Keywords

DepressionSeasonal affective disorderPhototherapyVitamin DEthicsMorals
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 6 , December 2020 , pp. 549 - 559
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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