Reuzel R P, van der Wilt G J, ten Have H A, de Vries Robbé P F
Department of Medical Technology Assessment, University of Nijmegen, Faculty of Medical Sciences, The Netherlands.
Med Health Care Philos. 1999;2(3):255-63. doi: 10.1023/a:1009963018813.
Health technology assessment (HTA) is often biased in the sense that it neglects relevant perspectives on the technology in question. To incorporate different perspectives in HTA, we should pursue agreement about what are relevant, plausible, and feasible research questions; interactive technology assessment (iTA) might be suitable for this goal. In this way a kind of procedural ethics is established. Currently, ethics too often is focussed on the application of general principles, which leaves a lot of confusion as to what really is the matter in specific cases; in an iTA clashes of values should not be approached by use of such ethics. Instead, casuistry, as a tool used within the framework of iTA, should help to articulate and clarify what is the matter, as to make room for explication and consensus building.
卫生技术评估（HTA）往往存在偏差，因为它忽视了对相关技术的不同观点。为了将不同观点纳入卫生技术评估，我们应该就哪些是相关、合理且可行的研究问题达成共识；交互式技术评估（iTA）可能适合这一目标。通过这种方式建立了一种程序伦理。目前，伦理常常侧重于一般原则的应用，这使得在具体案例中究竟什么才是关键问题存在很多困惑；在交互式技术评估中，不应通过使用这种伦理来处理价值冲突。相反，决疑法作为在交互式技术评估框架内使用的一种工具，应有助于阐明和澄清问题所在，从而为解释和建立共识留出空间。
