Centre intégré universitaire de santé et services sociaux (CIUSSS) de l'Estrie - Centre hospitalier de l'université de Sherbrooke (CHUS).
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.
Int J Technol Assess Health Care. 2018 Jan;34(5):447-457. doi: 10.1017/S0266462318000508. Epub 2018 Oct 9.
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.
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.
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.
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.
将伦理学纳入健康技术评估（HTA）仍然是 HTA 从业者面临的挑战。我们对与 HTA 中的伦理分析相关的社会和方法问题进行了系统回顾。我们考察了：（1）将伦理学纳入的原因（社会需求）；（2）伦理整合的障碍；（3）在 HTA 中伦理评估（特别是价值判断）和对伦理评估的正式实验的批判性分析中使用的概念和过程。
搜索标准包括“伦理”、“技术评估”和“HTA”。文献检索在 Medline/Ovid、SCOPUS、CINAHL、PsycINFO 和国际 HTA 数据库中进行。两名独立评审员的两个小组分别进行了引文筛选、全文筛选和数据提取。从文章中提取的数据使用一般归纳法分为几类。
去除重复项后，仍保留了 1646 条引文列表。其中，132 篇进行了全面审查，有 67 篇符合条件的文章进行了分析。报道最多的社会需求是为政策决策提供信息。最常提到的整合障碍是缺乏共享的伦理分析标准模型。公平和公平以及原则主义中嵌入的价值观是与伦理评估最常提到的价值观。
与科学实验范式相比，HTA 中没有既定的伦理学程序，也没有关于伦理理论和伦理专业知识作用的共识，这阻碍了其整合。我们的研究结果使我们能够假设，在这项工作中研究的三个问题之间存在相互依存关系，价值判断可能是它们的连接概念。
