Eliciting Value-Judgments in Health Technology Assessment: An Applied Ethics Decision Making Paradigm

Abstract

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