Technology Assessment and the Sociopolitics of Health Technologies

Abstract

In a growing number of countries, health technology assessment (HTA) has come to be seen as a vital component in policy making. Even though the assessment of the social, political, and ethical aspects of health technology is listed as one of its main objectives, in practice, the integration of such dimensions into HTA remains limited. Recent social scientific research on the inherently political nature of technology strongly supports such a comprehensive approach. The growing claims by and on behalf of consumer groups also suggest that HTA should be informed by a broader set of perspectives. Using the example of the cochlear implant in children, this essay compares the professed objectives of HTA with typical practice and explores possible explanations for the discrepancies observed. A second example, home telemonitoring for elderly persons, demonstrates how the types of evidence considered by HTA and the process through which assessments are produced may be reconsidered. We argue for the formal integration of the sociopolitical dimensions of health care technologies into assessments. The ability of HTA to more fully address important issues from a public policy point of view will increase by making explicit the sociopolitical nature of health care technologies.

A systematic literature review of the effectiveness of non-pharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use

“…Increasingly, critics argue that health and technology assessment studies must pay greater attention to the social, political and ethical issues associated with technologies 114,115 and that the perspectives of patients and their carers and relatives should be given greater emphasis. 116 Such issues are particularly important in considering the overall effectiveness of interventions to manage wandering amongst people with dementia, owing to the potential ethical and social implications of these interventions.…”

LIFELAX – diet and LIFEstyle versus LAXatives in the management of chronic constipation in older people: randomised controlled trial

“…104,112 More localised critiques have investigated the assumptions that underpin outcomes themselves or the methods by which they are reached. 95 Much less work has investigated the specifics of HTA as a field of practice, the sociotechnical networks in which knowledge about efficacy is defined and generated, negotiations about criteria for its adequacy or the procedures through which these are enacted in concrete practices.…”

Evidence Based Health Policy-Making and Health Technology Assessment: Review

“…14 Tek no lo ji nin sos yal, etik, hu ku ki ve di ğer sistem ler üze rin de ki et ki si nin dik ka te alın ma sı nın öne mi er ken an la şıl mış ve da ha son ra da ge nel olarak ka bul edil miş tir. [15][16][17] STD'de etik kay gı la rın öne mi üç ön gö rü ye da yan mak ta dır. 11,18 Bi rin ci si; sağ lık tek no lo ji le ri nin uy gu lan ma sı nın ah la ki sonuç lar do ğu ra ca ğı dır ki ge le nek sel ma li yet ve et kili lik de ğer len dir me le ri ne etik ana liz ek len me si ni açık la mak ta dır.…”