We need to talk about values: framework for articulating normative reasoning in HTA
This framework helps make clear the values and ethical reasoning used in health technology assessment (HTA). Since HTA decisions are not just based on data but also on value judgments, this tool provides a structured way to express those judgments clearly and consistently, so decisions are more transparent and fair.
At a glance
Use when
Developing or reviewing HTA recommendations where value judgments play a key role; seeking to improve public accountability and ethical justification of decisions; training HTA practitioners in normative analysis
Avoid when
When only empirical evidence synthesis is required without value deliberation; in settings where explicit discussion of values is institutionally prohibited or suppressed
Inputs
Value judgments, ethical considerations, policy goals, and empirical evidence from HTA processes
Outputs
Structured documentation of normative reasoning, transparent justification of value-based decisions in HTA
How it works
The framework provides a conceptual structure for articulating normative reasoning in HTA by defining key terms and distinguishing between types of normative commitments (e.g., ethical principles, social values, procedural norms). Developed through cross-disciplinary collaboration of 24 researchers, it enables HTA practitioners to systematically document and justify value-laden choices. Applied to a hypothetical case, it demonstrates how to enhance transparency, coherence, and accountability in decision-making processes within healthcare priority-setting.
- HTA domains
- Organisational aspects, Patient and Social Aspects, Aspects Beyond HTA
- Assumptions
- HTA inherently involves value-laden decisions; transparency in normative reasoning improves legitimacy and public trust; a shared language for values enhances accountability
- Strengths
- Improves transparency and consistency in value-based reasoning; supports ethical scrutiny; developed through multidisciplinary expert collaboration; applicable across different HTA systems
- Limitations
- Requires cultural and institutional willingness to articulate values explicitly; may be challenging to implement in politically sensitive contexts; not a decision rule but a communication and structuring tool
- Also known as
- Framework for Articulating Normative Reasoning in HTA, Normative Reasoning Framework in HTA
Questions this answers
- › What values underlie a given HTA decision?
- › How are ethical principles applied in technology assessment?
- › How can value-based reasoning be made more transparent in HTA?
- › What types of normative commitments influence priority-setting in healthcare?
- › How can HTA decisions be better justified to the public?
- › How can inconsistencies in the use of value language in HTA be reduced?
References & sources
Similar by meaning
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