Charlton, Victoria;
Distefano, Michael;
Mitchell, Polly;
Morrell, Liz;
Rand, Leah;
Badano, Gabriele;
Baker, Rachel;
... Wester, Gry; + view all
(2023)
We need to talk about values: a proposed framework for
the articulation of normative reasoning in health
technology assessment.
Health Economics, Policy and Law
pp. 1-20.
10.1017/S1744133123000038.
(In press).
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Abstract
It is acknowledged that health technology assessment (HTA) is an inherently value-based activity that makes use of normative reasoning alongside empirical evidence. But the language used to conceptualise and articulate HTA's normative aspects is demonstrably unnuanced, imprecise, and inconsistently employed, undermining transparency and preventing proper scrutiny of the rationales on which decisions are based. This paper – developed through a cross-disciplinary collaboration of 24 researchers with expertise in healthcare priority-setting – seeks to address this problem by offering a clear definition of key terms and distinguishing between the types of normative commitment invoked during HTA, thus providing a novel conceptual framework for the articulation of reasoning. Through application to a hypothetical case, it is illustrated how this framework can operate as a practical tool through which HTA practitioners and policymakers can enhance the transparency and coherence of their decision-making, while enabling others to hold them more easily to account. The framework is offered as a starting point for further discussion amongst those with a desire to enhance the legitimacy and fairness of HTA by facilitating practical public reasoning, in which decisions are made on behalf of the public, in public view, through a chain of reasoning that withstands ethical scrutiny.
| Type: | Article |
|---|---|
| Title: | We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1017/S1744133123000038 |
| Publisher version: | http://dx.doi.org/10.1017/s1744133123000038 |
| Language: | English |
| Additional information: | © National Institutes of Health and the Author(s), 2023. To the extent this is a work of the US Government, it is not subject to copyright protection within the United States. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. |
| Keywords: | healthcare priority-setting, ethics, social values, moral values, practical public reasoning |
| 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/10186639 |
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