1. Ethical issues

1.1. Use of technology

The practice of HTA focuses on existing or new technologies. How a technology is used will determine the scope of the ethical issues associated with that technology. If a technology is used in a different way or setting, the scope of ethical issues associated with it will likely vary. For example, genetic testing to see how likely an individual might

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.


Short recap of Beneficence and Non-maleficence

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.