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Exorcising the positivist ghost in the priority-setting machine: NICE and the demise of the 'social value judgement'

Charlton, V; Weale, A; (2021) Exorcising the positivist ghost in the priority-setting machine: NICE and the demise of the 'social value judgement'. Health Economics, Policy and Law , 16 (4) pp. 505-511. 10.1017/S1744133121000049. Green open access

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Abstract

The National Institute for Health and Care Excellence (NICE), the UK's primary health care priority-setting body, has traditionally described its decisions as being informed by 'social value judgements' about how resources should be allocated across society. This paper traces the intellectual history of this term and suggests that, in NICE's adoption of the idea of the 'social value judgement', we are hearing the echoes of welfare economics at a particular stage of its development, when logical positivism provided the basis for thinking about public policy choice. As such, it is argued that the term offers an overly simplistic conceptualisation of NICE's normative approach and contributes to a situation in which NICE finds itself without the necessary language fully and accurately to articulate its basis for decision-making. It is suggested that the notion of practical public reasoning, based on reflection about coherent principles of action, might provide a better characterisation of the enterprise in which NICE is, or hopes to be, engaged.

Type: Article
Title: Exorcising the positivist ghost in the priority-setting machine: NICE and the demise of the 'social value judgement'
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S1744133121000049
Publisher version: https://doi.org/10.1017/S1744133121000049
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Health care priority-setting, National Institute for Health and Care Excellence, health technology assessment, practical public reasoning, resource allocation
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL SLASH
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS > Dept of Political Science
URI: https://discovery.ucl.ac.uk/id/eprint/10122448
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