Chapter

Health Technology Assessment Implementation: The Politics of Ethics

Daniel Callahan

in The Roots of Bioethics

Published in print October 2012 | ISBN: 9780199931378
Published online January 2013 | e-ISBN: 9780199980598 | DOI: http://dx.doi.org/10.1093/acprof:oso/9780199931378.003.0017
Health Technology Assessment Implementation: The Politics of Ethics

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Using a 2009 American debate on a federal public health recommendation on mammography screening for women younger than the age of 50 as a case study, it is argued that public acceptance of health technology assessment depends on the ethical acceptability of its recommendations. At the same time, that acceptability cannot be separated from the politics and values of the healthcare system of which it is part. In the United States, those values display a sharp ideological split between a conservative individual-based ethic and a liberal communitarian-oriented ethic. A clash of this kind cannot be solved by invocation of ethical principles when it is those principles themselves that are in conflict. Inevitably, acceptance of health technology assessment is threatened by this conflict as is the fate of healthcare reform. In a rather disturbing and paradoxical way, once ethical values become dominant in a political debate, compromise and nuanced dialogue seems to become harder not easier.

Keywords: technology assessment; ethics; cancer; mammography guidelines; controversy

Chapter.  5575 words. 

Subjects: Moral Philosophy

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