Toward a procedure for integrating moral issues in health technology assessment

Hofmann, Bjørn

doi:10.1017/s0266462305050415

Cited by 115 publications

(197 citation statements)

References 20 publications

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“…The panel was asked to deliberate on the ethical and societal questions raised by these technologies, based on a list of 'moral' questions developed by BjØrn Hofmann. 28 They were also offered the opportunity to add questions to the assessment of these technologies, which was being conducted by OHTAC and MAS. Specifically, we asked the following three discussion questions:…”

Section: Data Collection and Analysismentioning

confidence: 99%

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Citizens' perspectives on personalized medicine: a qualitative public deliberation study

et al. 2013

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Our objective was to explore citizens' informed and reasoned values and expectations of personalized medicine, a timely yet novel genomics policy issue. A qualitative, public deliberation study was undertaken using a citizens' reference panel on health technologies, established to provide input to the health technology assessment process in Ontario, Canada. The citizens' panel consisted of five women and nine men, aged 18-71 years, with one member selected from each health authority region. There were shared expectations among the citizens' panel members for the potential of personalized medicine technologies to improve care, provided they are deemed clinically valid and effective. These expectations were tempered by concerns about value for money and the possibility that access to treatment may be limited by personalized medicine tests used to stratify patients. Although they questioned the presumed technological imperative presented by personalized medicine technologies, they called for increased efforts to prepare the health-care system to effectively integrate these technologies. This study represents an early but important effort to explore public values toward personalized medicine. This study also provides evidence of the public's ability to form coherent judgments about a new policy issue. Concerned that personalized tests might be used to ration care, they suggested that treatment should be made available if patients wanted it, irrespective of tests that indicate little benefit. This issue raises clinical and policy challenges that may undermine the value of personalized medicine. Further efforts to deliberate with the public are warranted to inform effective, efficient and equitable translation of personalized medicine.

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Section: Data Collection and Analysismentioning

confidence: 99%

“…Which ethical and social questions from Hofmann's list 28 need to be applied to: (a) GEP; and (b) personalized medicine, in general?…”

Section: Data Collection and Analysismentioning

confidence: 99%

Citizens' perspectives on personalized medicine: a qualitative public deliberation study

et al. 2013

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“…Indeed, as one early reviewer of this study maintained, defining the core questions was the basis for the entire EUnetHTA project, which also relied on Hofmann's (16) work. The authors of the ethics section of the EUnetHTA document acknowledge that the approaches currently used and described in the document had been identified and defined by the INAHTA Ethics Working Group (9).…”

Section: Discussionmentioning

confidence: 99%

Tackling ethical issues in health technology assessment: A proposed framework

Burls

Caron

Langavant

et al. 2011

Int J Technol Assess Health Care

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Objectives: Values are intrinsic to the use of health technology assessments (HTAs) in health policy, but neglecting value assumptions in HTA makes their results appear more robust or normatively neutral than may be the case. Results of a 2003 survey by the International Network of Agencies for Health Technology Assessment (INAHTA) revealed the existence of disparate methods for making values and ethical issues explicit when conducting HTA.Methods: An Ethics Working Group, with representation from sixteen agencies, was established to develop a framework for addressing ethical issues in HTA. Using an iterative approach, with email exchanges and face-to-face workshops, a report on Handling Ethical Issues was produced.Results: This study describes the development process and the agreed upon framework for reflexive ethical analysis that aims to uncover and explore the ethical implications of technologies through an integrated, context-sensitive approach and situates the proposed framework within previous work in the development of ethics analysis in HTA.Conclusions: It is important that methodological approaches to address ethical reflection in HTA be integrative and context sensitive. The question-based approach described and recommended here is meant to elicit this type of reflection in a way that can be used by HTA agencies. The questions proposed are considered only as a starting point for handling ethics issues, but their use would represent a significant improvement over much of the existing practice.

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“…Her er poenget at når man gjør en vurdering av de etiske utfordringene ved en teknologi, er det hensiktsmessig å undersøke og gjøre rede for utfordringene ved den teknologien den bygger på (fosterdiagnostikk) og grenser til (KUB) (Hofmann 2005). Dessuten kan ny teknologi kaste nytt lys over gamle problemstillinger.…”

Section: Diskusjonunclassified