ETHICS IN HEALTH TECHNOLOGY ASSESSMENT: A SYSTEMATIC REVIEW

Area of Science:

• Health Technology Assessment (HTA)
• Bioethics
• Health Policy Analysis

Background:

• Ethical considerations are crucial for health technology assessment (HTA) but face integration challenges.
• Practitioners require guidance on incorporating ethical analysis into HTA processes.
• Social needs and methodological issues impact the ethical dimension of HTA.

Purpose of the Study:

• To systematically review social and methodological issues in ethical analysis within HTA.
• To identify reasons for integrating ethics, obstacles, and concepts/processes in ethical evaluation.
• To critically analyze formal experimentations of ethical evaluation in HTA.

Main Methods:

• Systematic literature review using keywords: "ethic," "technology assessment," and "HTA."
• Searches conducted across multiple databases including Medline/Ovid, SCOPUS, CINAHL, PsycINFO, and the international HTA Database.
• Data extraction and categorization using a general inductive method by independent reviewers.

Main Results:

• 67 articles were eligible for analysis from an initial 1,646 citations.
• Informing policy decision-making was the primary social need identified.
• Lack of standardized models for ethical analysis was the most significant obstacle.
• Fairness, Equity, and Principlism were frequently cited values in ethical evaluations.

Conclusions:

• There is a lack of settled proceedings and consensus on the role of ethical theory and expertise in HTA.
• An interdependence exists between social needs, obstacles, and ethical evaluation processes in HTA.
• Value judgments are hypothesized as a potential linking concept for ethical integration in HTA.