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ETHICS IN HEALTH TECHNOLOGY ASSESSMENT: A SYSTEMATIC REVIEW

Published online by Cambridge University Press:  09 October 2018

Christian A. Bellemare
Affiliation:
Centre intégré universitaire de santé et services sociaux (CIUSSS) de l'Estrie – Centre hospitalier de l'université de Sherbrooke (CHUS) Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke
Pierre Dagenais
Affiliation:
Centre intégré universitaire de santé et services sociaux (CIUSSS) de l'Estrie – Centre hospitalier de l'université de Sherbrooke (CHUS), Faculté de médecine et des sciences de la santé de l'Université de Sherbrooke Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke, CHUS Hôtel-Dieupierre.dagenais@usherbrooke.ca
Suzanne K.-Bédard
Affiliation:
Centre intégré universitaire de santé et services sociaux (CIUSSS) de l'Estrie – Centre hospitalier de l'université de Sherbrooke (CHUS) Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke
Jean-Pierre Béland
Affiliation:
Unité d'enseignement en éthique Département des sciences humaines, Université du Québec à Chicoutimi (UQAC) Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke
Louise Bernier
Affiliation:
Faculté de droit, Université de Sherbrooke
Charles-Étienne Daniel
Affiliation:
Faculté de droit, Université de Sherbrooke Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke
Hubert Gagnon
Affiliation:
Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke
Georges-Auguste Legault
Affiliation:
Faculté de droit, Université de Sherbrooke AND Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke
Monelle Parent
Affiliation:
Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke
Johane Patenaude
Affiliation:
Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke Institut interdisciplinaire d'innovation technologique (3IT) de l'Université de Sherbrooke

Abstract

Objectives:

Integration of ethics into health technology assessment (HTA) remains challenging for HTA practitioners. We conducted a systematic review on social and methodological issues related to ethical analysis in HTA. We examined: (1) reasons for integrating ethics (social needs); (2) obstacles to ethical integration; (3) concepts and processes deployed in ethical evaluation (more specifically value judgments) and critical analyses of formal experimentations of ethical evaluation in HTA.

Methods:

Search criteria included “ethic,” “technology assessment,” and “HTA”. The literature search was done in Medline/Ovid, SCOPUS, CINAHL, PsycINFO, and the international HTA Database. Screening of citations, full-text screening, and data extraction were performed by two subgroups of two independent reviewers. Data extracted from articles were grouped into categories using a general inductive method.

Results:

A list of 1,646 citations remained after the removal of duplicates. Of these, 132 were fully reviewed, yielding 67 eligible articles for analysis. The social need most often reported was to inform policy decision making. The absence of shared standard models for ethical analysis was the obstacle to integration most often mentioned. Fairness and Equity and values embedded in Principlism were the values most often mentioned in relation to ethical evaluation.

Conclusions:

Compared with the scientific experimental paradigm, there are no settled proceedings for ethics in HTA nor consensus on the role of ethical theory and ethical expertise hindering its integration. Our findings enable us to hypothesize that there exists interdependence between the three issues studied in this work and that value judgments could be their linking concept.

Type
Method
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

The authors thank the information scientists Mykola Krupko and Francis Lacasse. The authors thank Mrs. Rina Kampeas and Louise Corbeil for editorial work on the manuscript. This work was supported by the Canadian Institutes of Health Research (J.P., grant number 142187). We the authors below attest that (1) each author contributed to the conception and design or analysis and interpretation of data and the writing of the study; (2) each has approved the version being submitted; and (3) the content has not been published nor is being considered for publication elsewhere.

References

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