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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 Gjøvikb.m.hofmann@medisin.uio.no
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
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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 

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