2. Ethical issues
1. Ethical issues
1.1. Use of technology
HTA’s purpose is ’...to inform decision-making in order to promote an
equitable, efficient, and high-quality health system’ (INAHTA definition 2020).
Assessing a technology can provide important information about the balance
between beneficence (doing good) and non-maleficence (doing no
harm). In the end, individual practitioners and patients will ultimately decide
whether a technology will be used or not in a particular case.
Research should be worthwhile and provide value that outweighs any risk or harm. Researchers should aim to maximise the benefit of the research and minimise potential risk of harm to participants and researchers. All potential risk and harm should be mitigated by robust precautions.
The need for a favourable risk/benefit assessment requires an assessment of the probabilities of both the harms and of the benefits that may arise. The term ‘risk’ is generally used for harms but the probability of benefits also needs to be considered. Many kinds of possible harms and benefits need to be taken into account. There are, for example, risks of psychological harm, physical harm, legal harm, societal harm and economic harm and the corresponding benefits. While the most likely types of harms to research participants are those of psychological or physical pain or injury, there may be others costs of a societal nature to consider.
Discovering what will in fact provide a benefit may require exposing
persons to some risk. Conducting research without any risk of causing harm
would prevent many improvements in human welfare. Where the participant may
benefit directly through the research, such risks are more justifiable.
However, where the research project will not benefit the participants directly,
the wider benefits to others in terms of the potential to alleviate disease or
other harms in the future may justify research with some risk but only after
very careful evaluation.