文章基本信息

标题：Eliciting Value-Judgments in Health Technology Assessment: An Applied Ethics Decision Making Paradigm
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作者：Georges-Auguste Legault ; Suzanne K.-Bédard ; Jean-Pierre Béland 等
期刊名称：Open Journal of Philosophy
印刷版ISSN：2163-9434
电子版ISSN：2163-9442
出版年度：2021
卷号：11
期号：2
页码：307-325
DOI：10.4236/ojpp.2021.112021
语种：English
出版社：Scientific Research Publishing
摘要：The worldwide COVID-19 pandemic has shed more light on the difficulty of making health care decisions integrating scientific knowledge and values associated to life and death issues, human suffering, quality of life, economic losses, liberty of movement, etc. But the difficulties related to health care decisions and the use of innovative drugs or technologies are not new, and many countries have created agencies that have the mandate to evaluate new technologies in health care. Health Technological Assessment (HTA) reports’ aim is to guide the decision makers in these difficult matters. There are two ethical components in HTA. The first is the report’s presentation of an ethical evaluation of the technology. The second is the value-ladenness of the HTA decision-making process itself. When implicit value judgments are not elicited, the justification of the final decision cannot be transparent. The present paper aims to identify and elicit the implicit value-judgments related to each step of the HTA process. This research is grounded on an applied ethics decision-making paradigm based on the role of value judgments in the decision-making process. The first part discusses two different approaches to values and value judgments in HTA. In the second part, citations mentioning value judgments extracted from a systematic review on the integration of ethics into HTA were categorized to elicit the value judgments and their criteria for each different HTA decision-making steps. The results show that there are 18 decision-making steps in the HTA process where 23 implicit value-judgments can be recognized. The range of these value judgments encompasses the whole HTA process: from the initial request, the presenting of the principal issues, to the final report’s dissemination. Since stakeholders need to understand which value judgments the conclusion of a report relies on, eliciting the implicit value judgments in the HTA decision-making process should yield more transparency.
关键词：Applied Ethics;Health Technology Assessment;Decision-Making Paradigm;Value Judgments;Values