The normative basis of (health) technology assessment and the role of ethical expertise

Abstract

The role of normative reflection and the possibilities of ethical inquiry in technology assessment have been under discussion in the TA community for several years. As an outcome of this discussion the necessity of explicitly dealing with normativity in TA has widely been acknowledged. However, it is still quite unclear in which way this should be done. This paper is dedicated to the role (and limitations) of ethical expertise in this field, especially in HTA. By methodological analysis an approach is developed to show how entry points for ethical expertise could be identified. The result is that ethical expertise can inform moral debates by uncovering underlying assumptions, by making the normative structure of argumentation transparent, and by weighing the strength of the arguments. In this way moral debates in HTA can become more transparent and opened to argumentative reasoning instead of consisting of bargaining processes determined by power distributions. Ethical reflection, however, does not replace decision-making.