Philosophers engaged in the field of applied ethics are often challenged to revisit certain philosophical debates in order to clarify the background concepts involved in a given undertaking at stake. This is particularly evident in the field of Health Technological Assessment (HTA) where the integration of ethics has been a debate for many years. Interdisciplinary technological assessment involves a head-on discussion between the frame of reference of natural sciences and those of philosophy, which often reproduce the fact/value dichotomy debated in the field of philosophy. The challenge for a philosopher is then to explain how the fact/value dichotomy has been criticized by philosophers in such a way that the distinction between “verifiable facts” and “unverifiable values” cannot be accounted for anymore. The critiques of H. Putnam and S. E. Toulmin were the first steps towards the understanding of the dichotomy. A speech act approach, based on J. L. Austin illocutionary acts, can shed a new light on this issue by clarifying the difference between assertions, evaluations and prescriptions. By using a speech-act approach we can define the respective role of scientific evaluation and ethical evaluation in the HTA process and offer a better guide for the decision-makers on all aspects of adopting a technological development in health.
Assasi, N., Schwartz, L., Tarride, J. E., O’Reilly, D., & Goeree, R. (2015). Barriers and Facilitators Influencing Ethical Evaluation in Health Technology Assessment. International Journal of Technology Assessment in Health Care, 31, 113-123.
Burls, A., Caron, L., Cleret de Langavant, G., Dondorp, W., Harstall, C., Pathak-Sen, E., & Hofmann, B. (2011). Tackling Ethical Issues in Health Technology Assessment: A Proposed Framework. International Journal of Technology Assessment in Health Care, 27, 230-237. https://doi.org/10.1017/S0266462311000250
Hofmann, B. M., Bond, K., & Sandman, L. (2018). Evaluation Facts and Facting Evaluation: On the Fact-Value Relationship in HTA. Journal of Evaluation and Clinical Practice, 24, 957-965. https://doi.org/10.1111/jep.12920
Legault, G. A., Patenaude, J., & Parent, M. (2010). Les Comités d’éthique de la recherche sur l’humain: Les chercheurs face aux enjeux d’internormativité et de gouvernance. Revue de droit de l'Université de Sherbrooke, 40, 383-407.
Martin, C., Williams-Jones, B., & de Ortúzar, M. G. (2011). Ethical Health Technology Assessment in Latin America: Lessons from Canada and Argentina. Acta Bioethica, 17, 225-236. https://doi.org/10.4067/S1726-569X2011000200009
Patenaude, J., Legault, G.-A., Bernier, L., Beauvais, J., Béland, J.-P., Boissy, P., & Tapin, D. (2015). Framework for the Analysis of Nanotechnologies’ Impacts and Ethical Acceptability: Basis of an Interdisciplinary Approach to Assessing Novel Technologies. Science and Engineering Ethics, 21, 293-315.
Refolo, P., Sacchini, D., Brereton, L., Gerhardus, A., Hofmann, B., Lysdahl, K. B., & Spagnolo, A. G. (2016). Why Is It so Difficult to Integrate Ethics in Health Technology Assessment (HTA)? The Epistemological Viewpoint. European Review for Medical & Pharmacological Sciences, 20, 4202-4208.