Institut Interdisciplinaire d'Innovation Technologique (3IT) de l'Université de Sherbrooke, Parc Innovation P2, 3000 boulevard de l'Université Sherbrooke, Sherbrooke, QC, Canada, J1K 0A5.
Faculté de Droit, Université de Sherbrooke, 2500 Boul. de l'Université, Sherbrooke, QC, Canada, J1K 2R1.
Int J Technol Assess Health Care. 2020 Oct 28;37:e9. doi: 10.1017/S0266462320000793.
Integration of ethics into technology assessment in healthcare (HTA) reports is directly linked to the need of decision makers to provide rational grounds justifying their social choices. In a decision-making paradigm, facts and values are intertwined and the social role of HTA reports is to provide relevant information to decision makers. Since 2003, numerous surveys and discussions have addressed different aspects of the integration of ethics into HTA. This study aims to clarify how HTA professionals consider the integration of ethics into HTA, so an international survey was conducted in 2018 and the results are reported here.
A survey comprising twenty-two questions was designed and carried out from April 2018 to July 2018. Three hundred and twenty-eight HTA agencies from seventy-five countries were invited to participate in this survey.
Eighty-nine participants completed the survey, representing a participation rate of twenty-seven percent. As to how HTA reports should fulfill their social role, over 84 percent of respondents agreed upon the necessity to address this role for decision makers, patients, and citizens. At a lower level, the same was found regarding the necessity to make value-judgments explicit in different report sections, including ethical analysis. This contrasts with the response-variability obtained on the status of ethical analysis with the exception of the expertise required. Variability in stakeholder-participation usefulness was also observed.
This study reveals the importance of a three-phase approach, including assessment, contextual data, and recommendations, and highlights the necessity to make explicit value-judgments and have a systematic ethical analysis in order to fulfill HTA's social role in guiding decision makers.
将伦理学纳入医疗保健技术评估（HTA）报告中，与决策者提供合理依据来证明其社会选择的必要性直接相关。在决策范式中，事实和价值观相互交织，HTA 报告的社会作用是向决策者提供相关信息。自 2003 年以来，许多调查和讨论都涉及到将伦理学纳入 HTA 的不同方面。本研究旨在阐明 HTA 专业人员如何考虑将伦理学纳入 HTA，因此于 2018 年进行了一项国际调查，并在此报告结果。
设计并于 2018 年 4 月至 7 月进行了一项包含 22 个问题的调查。邀请来自 75 个国家的 328 个 HTA 机构参与这项调查。
89 名参与者完成了调查，参与率为 27%。关于 HTA 报告应如何履行其社会作用，超过 84%的受访者认为有必要为决策者、患者和公民履行这一角色。在较低的层面上，对于在不同报告部分（包括伦理分析）明确表达价值判断的必要性，也得到了同样的回应。这与在伦理分析方面获得的反应可变性形成对比，除了所需的专业知识外。在利益相关者参与的有用性方面也观察到了可变性。
本研究揭示了包括评估、背景数据和建议的三阶段方法的重要性，并强调了明确表达价值判断和进行系统伦理分析的必要性，以履行 HTA 在指导决策者方面的社会作用。
