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We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment
Date Issued
27 September 2023
Date Available
20T16:51:40Z November 2023
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.
Other Sponsorship
Wellcome Trust Society and Ethics Doctoral Studentship
Clinical Center Department of Bioethics - the Intramural Program of the US National Institutes of Health
Arnold Ventures
Type of Material
Journal Article
Publisher
Cambridge University Press
Journal
Health Economics, Policy and Law
Start Page
1
End Page
21
Copyright (Published Version)
2023 National Institutes of Health and the Authors
Language
English
Status of Item
Peer reviewed
ISSN
1744-1331
This item is made available under a Creative Commons License
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Name
Charlton et al (2023) We need to talk about values; a proposed framework for the articulation of normative reasoning in health technology assessment; Health Econ Pol and Law.pdf
Size
375.08 KB
Format
Owning collection
Scopus© citations
0
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