Ethik im health technology assessment - Anspruch und umsetzung

Although part of the classical definition of Health Technology Assessment, analyses of ethical implications of health-related technology and its use fail to be addressed in the majority of HTA projects. On the one hand, this may be due to conceptual uncertainty arising from the tension between individual and socio-ethical values. On the other hand, the focus of assessments in the "HTA community" has mainly been on effectiveness and cost-effectiveness of interventions, which led to a lack of methodology for the analyses of moral implications. Still, a number of methodological papers have been published since the late 1990s, suggesting approaches to address ethical issues in HTA. Within the given framework for HTA (available resources, competencies, time frame) and against the background of almost generally accepted criteria for morally justifiable health care (respect of human dignity and integrity, consideration for balance of benefit and harms, need and solidarity, equity and cost-effectiveness) a predominantly descriptive approach seems to be most appropriate. Such an approach would focus on the systematic search for ethical tensions related to the use of technologies, on their description and discussion and, if necessary, on the initiation of thorough analyses in follow-up projects.