Different methods for ethical analysis in health technology assessment: an empirical study

Area of Science:

• Bioethics
• Health Technology Assessment (HTA)
• Ethical Analysis Methods

Background:

• Ethical analysis is crucial for HTA but often omitted in practice due to a lack of understanding of available methods.
• Different ethical analysis models exist, each with unique theoretical underpinnings and practical applications.

Purpose of the Study:

• To compare different methods for ethical analysis within the HTA process.
• To evaluate the properties and differences between various ethical analysis models.
• To assess the impact of method choice on ethical analysis outcomes in HTA.

Main Methods:

• Four distinct ethical analysis models were applied to bariatric surgery: axiological, casuist, principlist, and EUnetHTA.
• Each model independently evaluated ethical issues related to the chosen health technology.
• The study presented and compared the methodologies and findings of each ethical analysis model.

Main Results:

• All four methods identified common ethical themes, including personal responsibility, self-infliction, discrimination, justice, public funding, and stakeholder involvement.
• The axiological and EUnetHTA models encompassed a broader spectrum of arguments.
• Casuistry and principlism focused on a more concentrated set of prioritized arguments.

Conclusions:

• Multiple ethical analysis methods can be effectively employed within HTA.
• While not always identical, ethical analyses using different methods can yield substantially similar results.
• The core ethical conclusions from HTA are likely transferable across methods and international contexts.
• Consistent and transparent application of any ethical analysis method is more critical than the specific method chosen.