11.G. Skills building seminar: Navigating the ocean of data: unpacking ethical values in Health Technology Assessment
Authors:   Organised by: EUPHA-HTA, EUPHA-ETH, EUPHAnxt, HTAi,   Chair persons: Chiara de Waure (EUPHA-HTA), Jinane Ghattas (EUPHAnxt)
Published: October 2023

Abstract

Health technology assessment (HTA) is multidisciplinary process that uses explicit methods to determine the value of a health technology at different points in its lifecycle. The purpose is to implement an informed decision-making process in order to promote an equitable, efficient, and high-quality health system. Ethics has been identified as a key element in HTA because health care is a moral endeavour and potential technology presents complex moral dilemmas, especially with the rise of novel technologies. In evaluating health technologies, ethical aspects must be taken into account such as patients’ privacy and informed consent in terms of (re-)use of their personal sensitive data, alongside with the possibility of unintended consequences (e.g., doing more harm than good: Thalidomide case) and the effects on society in terms of justice and equity, with implications for financial sustainability. Without taking account of the ethical dimension in the process, choices may be made without considering the overall context of implementation, thus, compromising the relevance of decisions and policies, with potentially unintended consequences and/or harmful effects to the health and wellbeing of individuals/patients, to public health, to the environment, and to the society at large. Decision-makers should guarantee that adopted health technologies are meaningful and relevant for the society, with due consideration to their development too, to the extent possible, by also taking ethical aspects into consideration when evaluating health technology. Despite many years of recognising ethics as a foundational part of HTA, studies have shown that the ethical dimension is still not systematically and sufficiently addressed by means of ethical analysis. Furthermore, novel technologies, new types of data, and a paradigm shift in terms of how we generate and synthesize evidence, whilst providing us with unique opportunities in terms of HTA, pose concrete challenges and new (and revisited) dilemmas. EUPHA-HTA, EUPHA-ETH and EUPHAnxt sections and HTAi are committed to build capacity amongst healthcare professionals about evidence-based decision-making with due consideration to ethical aspects. The aim of this workshop is two-fold. First, we will discuss the role of ethics in healthcare decision-making and tools to ensure the integration of ethics in the HTA process. We will then explore case studies and present a simple model with the contribution of EUPHA-HTA, EUPHA-ETH, and HTAi to illustrate ethical dilemmas that can arise during HTA processes. In the second half of workshop, attendees will be divided into groups to discuss ethical challenges in HTA and means to overcome them. We will capture the needs and input of young researchers/audience and move towards developing a EUPHA-HTAi priority map for competency mapping as output.

Key messages
• Systematic real-world data collection and context-specific analysis of the ethical principles coupled with legal and social analysis contributes to good decision making and policies.
• Ethical analysis is an integral part of HTA, ensuring that the value=laden use of a health technology is made transparent, identifying ethical consent and dispute.

Speakers/Panelists
Elena Petelos
EUPHA-HTA, EUPHA-GH
Pietro Refolo
Università Cattolica del Sacro Cuore, Rome, Italy
Els Maeckelberghe
University Medical Center Groningen, Groningen, Netherlands
Wija Oortwijn
HTAi