Understanding the Normativity of Health Technology Assessment: Ontological, Moral, and Epistemological Commitments.

IF 1.8 3区哲学 Q2 ETHICS

Health Care Analysis Pub Date : 2024-06-17 DOI:10.1007/s10728-024-00487-x

Bart Bloemen, Wija Oortwijn, Gert Jan van der Wilt

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Abstract

The inherent normativity of HTA can be conceptualized as a result of normative commitments, a concept that we further specify to encompass moral, epistemological and ontological commitments at play in the practice of HTA. Based on examples from literature, and an analysis of the example of assessing Non-Invasive Prenatal Testing (NIPT), we will show that inevitable normative decisions in conducting an assessment commits the HTA practitioner to moral (regarding what makes a health technology desirable), ontological (regarding which effects of health technology are conceivable), and epistemological (regarding how to obtain reliable information about health technology) norms. This highlights and supports the need for integrating normative analysis and stakeholder participation, providing guidance to HTA practitioners when making normative choices. This will foster a shared understanding between those who conduct, use, or are impacted by assessments regarding what are conceivable and desirable outcomes of using health technology, and how to collect reliable information to assess whether these outcomes are (going to be) realized. It also provides more insight into the implications of different normative choices.

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理解卫生技术评估的规范性：本体论、道德和认识论承诺。

HTA 固有的规范性可被概念化为规范性承诺的结果，我们进一步明确了这一概念，以涵盖在 HTA 实践中发挥作用的道德、认识论和本体论承诺。根据文献中的例子和对无创产前检测（NIPT）评估例子的分析，我们将说明在进行评估时不可避免的规范性决策会使 HTA 从业者对道德（关于什么是可取的医疗技术）、本体论（关于医疗技术的哪些效果是可以想象的）和认识论（关于如何获得医疗技术的可靠信息）规范做出承诺。这凸显并支持了将规范分析与利益相关者参与相结合的必要性，在做出规范选择时为 HTA 从业人员提供指导。这将促进进行评估、使用评估或受评估影响的人员之间达成共识，即使用卫生技术的可想象和理想结果是什么，以及如何收集可靠信息以评估这些结果是否（将要）实现。它还能让人们更深入地了解不同规范选择的影响。

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来源期刊

Health Care Analysis Multiple-

CiteScore

4.20

自引率

0.00%

发文量

期刊介绍： Health Care Analysis is a journal that promotes dialogue and debate about conceptual and normative issues related to health and health care, including health systems, healthcare provision, health law, public policy and health, professional health practice, health services organization and decision-making, and health-related education at all levels of clinical medicine, public health and global health. Health Care Analysis seeks to support the conversation between philosophy and policy, in particular illustrating the importance of conceptual and normative analysis to health policy, practice and research. As such, papers accepted for publication are likely to analyse philosophical questions related to health, health care or health policy that focus on one or more of the following: aims or ends, theories, frameworks, concepts, principles, values or ideology. All styles of theoretical analysis are welcome providing that they illuminate conceptual or normative issues and encourage debate between those interested in health, philosophy and policy. Papers must be rigorous, but should strive for accessibility – with care being taken to ensure that their arguments and implications are plain to a broad academic and international audience. In addition to purely theoretical papers, papers grounded in empirical research or case-studies are very welcome so long as they explore the conceptual or normative implications of such work. Authors are encouraged, where possible, to have regard to the social contexts of the issues they are discussing, and all authors should ensure that they indicate the ‘real world’ implications of their work. Health Care Analysis publishes contributions from philosophers, lawyers, social scientists, healthcare educators, healthcare professionals and administrators, and other health-related academics and policy analysts.