Ethical Issues in Technology Assessment: Conceptual Categories and Procedural Considerations

The practice of health care technology assessment involves ethical considerations in all of its varied functions and techniques. Ethical issues in technology assessment can be grouped into the broad categories of normative concepts, diagnosis, prevention and therapy, research and the advancement of knowledge, and allocation of resources. Moreover, the ethics of the assessment process itself must be evaluated in terms of the integrity of the project's goals, procedures, and effects, and evaluators' open and self-critical acknowledgment of their purposes. As a relatively new field, technology assessment can benefit from using a variety of analytic approaches as it works to develop its own methods for evaluating ethical issues related to technology.

[1]  J. Avorn,et al.  Evaluating drugs after their approval for clinical use. , 1993, The New England journal of medicine.

[2]  J. Goodwin,et al.  The tomato effect. Rejection of highly efficacious therapies. , 1984, JAMA.

[3]  T. Chalmers,et al.  Minimizing the three stages of publication bias. , 1990, JAMA.

[4]  S O Thier,et al.  HIV testing is the answer--what's the question? , 1988, The New England journal of medicine.

[5]  B. Freedman.  Equipoise and the ethics of clinical research. , 1987, The New England journal of medicine.

[6]  D. Futuyma,et al.  Science On Trial , 1982 .

[7]  B. Brody,et al.  A multi-institution collaborative policy on medical futility. , 1996, JAMA.

[8]  Sox Hc,et al.  Setting Priorities for Health Technology Assessment: A Model Process , 1992 .

[9]  Engelhardt Ht.  Bioethics in pluralist societies. , 1982 .

[10]  V. Fuchs.  WHO SHALL LIVE? Health, Economics and Social Choice , 1976 .

[11]  J P Kassirer,et al.  Our stubborn quest for diagnostic certainty. A cause of excessive testing. , 1989, The New England journal of medicine.

[12]  J. Kankaanpää,et al.  Assessment of health care technologies : case studies, key concepts, and strategic issues , 1996 .

[13]  A L Greer,et al.  The State of the Art Versus the State of the Science: The Diffusion of New Medical Technologies into Practice , 1988, International Journal of Technology Assessment in Health Care.

[14]  E. Huth.  Irresponsible authorship and wasteful publication. , 1986, Annals of internal medicine.

[15]  P S Appelbaum,et al.  False hopes and best data: consent to research and the therapeutic misconception. , 1987, The Hastings Center report.

[16]  A Liberati,et al.  EUR-ASSESS Project Subgroup Report on Methodology: Methodological Guidance for the Conduct of Health Technology Assessment , 1997, International Journal of Technology Assessment in Health Care.

[17]  Technology transfer: trends in the federalization of biomedical research , 1996, Academic medicine : journal of the Association of American Medical Colleges.

[18]  K. Donelan,et al.  Discrimination against people with AIDS: the public's perspective. , 1988, The New England journal of medicine.

[19]  I. Kant,et al.  Groundwork for the Metaphysics of Morals , 2002 .

[20]  Engelhardt Ht.  T he disease of masturbation: values and the concept of disease. , 1974 .

[21]  I. K. Zola.  Pathways to the doctor-from person to patient. , 1973, Social science & medicine.

[22]  A. Relman.  Economic incentives in clinical investigation. , 1989, The New England journal of medicine.

[23]  C. Stocking,et al.  Ethics consultants' recommendations for life-prolonging treatment of patients in a persistent vegetative state. , 1993, JAMA.

[24]  A. Pablo Iannone,et al.  Contemporary moral controversies in technology , 1987 .

[25]  Tom L. Beauchamp,et al.  Ethics and epidemiology , 1998 .

[26]  R. Hahn,et al.  The state of federal health statistics on racial and ethnic groups. , 1992, JAMA.

[27]  T. Tymstra.  The Imperative Character of Medical Technology and the Meaning of “Anticipated Decision Regret” , 1989, International Journal of Technology Assessment in Health Care.

[28]  K. Simpson,et al.  Informing the Mammography Coverage Debate: Results of Meta-analysis, Computer Modeling, and Issue Analysis , 1991, International Journal of Technology Assessment in Health Care.

[29]  Bennett Jc.  Inclusion of women in clinical trials--policies for population subgroups. , 1993 .

[30]  S. Sontag.  Illness as Metaphor , 1978 .

[31]  M. Drummond,et al.  Health Care Technology: Effectiveness, Efficiency and Public Policy@@@Methods for the Economic Evaluation of Health Care Programmes , 1988 .

[32]  M. Thamer,et al.  The Status of Health Technology Assessment Worldwide: Results of an International Survey , 1997, International Journal of Technology Assessment in Health Care.

[33]  E G Knox,et al.  Confidential medical records and epidemiological research. , 1992, BMJ.

[34]  D. Mant,et al.  Mass screening: theory and ethics. , 1990, BMJ.

[35]  P Skrabanek,et al.  Mass Mammography: The Time for Reappraisal , 1989, International Journal of Technology Assessment in Health Care.

[36]  S B Thacker,et al.  The case for reassessment of health care technology. Once is not enough. , 1990, JAMA.

[37]  J C Bailar,et al.  Science, statistics, and deception. , 1986, Annals of internal medicine.

[38]  T A Sheldon,et al.  Race and ethnicity in health research. , 1992, Journal of public health medicine.

[39]  Leroy Hood,et al.  The Code of Codes Scientific and Social Issues in the Human Genome Project , 1992 .

[40]  I. Jatoi,et al.  American and European recommendations for screening mammography in younger women: a cultural divide? , 1993, BMJ.

[41]  Stanley Joel Reiser,et al.  Medicine and the reign of technology , 1979 .

[42]  M. Debakey,et al.  Medical centers of excellence and health reform. , 1993, Science.

[43]  L. Gostin,et al.  Conflict of interest dilemmas in biomedical research. , 1994, JAMA.

[44]  Albert R. Jonsen,et al.  The Abuse of Casuistry: A History of Moral Reasoning , 1988 .

[45]  N Freemantle,et al.  EUR-ASSESS Project Subgroup Report on Dissemination and Impact , 1997, International Journal of Technology Assessment in Health Care.

[46]  I. K. Zola,et al.  Medicine as an Institution of Social Control , 1972, The Sociological review.

[47]  R. Hamel,et al.  A Matter of Principles?: Ferment in U.S. Bioethics , 1994 .

[48]  Michael J. Malinowski,et al.  Capitation, Advances in Medical Technology, and the Advent of a New Era in Medical Ethics , 1996, American Journal of Law & Medicine.

[49]  T. Beauchamp,et al.  Principles of biomedical ethics , 1991 .

[50]  J. Kassirer,et al.  Clinical research--what should the public believe? , 1994, The New England journal of medicine.

[51]  G. E. Steffen,et al.  Quality medical care. A definition. , 1988, JAMA.

[52]  C. Dougherty.  Ethical Perspectives on Prospective Payment , 1989 .

[53]  Bernard Barber,et al.  Resistance by scientists to scientific discovery. , 1961, Science.

[54]  K. Inman,et al.  Problems in Assessing the Technology of Critical Care Medicine , 1992, International Journal of Technology Assessment in Health Care.

[55]  J. Mckinlay.  From "promising report" to "standard procedure": seven stages in the career of a medical innovation. , 1981, The Milbank Memorial Fund quarterly. Health and society.

[56]  Wija Oortwijn,et al.  Priority Setting for Health Technology Assessment: Theoretical Considerations and Practical Approaches: A paper produced by the Priority Setting Subgroup of the EUR-ASSESS Project , 1997, International Journal of Technology Assessment in Health Care.

[57]  A. Musschenga.  The relation between concepts of quality-of-life, health and happiness. , 1997, The Journal of medicine and philosophy.

[58]  S Hellman,et al.  Of mice but not men. Problems of the randomized clinical trial. , 1991, The New England journal of medicine.

[59]  E. Passamani,et al.  Clinical trials--are they ethical? , 1991, The New England journal of medicine.

[60]  Peer and/or peerless review. Some vagaries of the editorial process. , 1985, Archives of surgery.

[61]  J. H. Comroe,et al.  Scientific basis for the support of biomedical science. , 1976, Science.

[62]  F. Mosteller,et al.  Introduction: Using Medical Registries and Data Sets for Technology Assessment , 1991, International Journal of Technology Assessment in Health Care.