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Eliciting ethical and social values in health technology assessment: A participatory approach


  • Bombard, Yvonne
  • Abelson, Julia
  • Simeonov, Dorina
  • Gauvin, Francois-Pierre


Despite a growing consensus that ethical and social values should be addressed in health technology assessment (HTA) processes, there exist a variety of methods for doing so. There is growing interest in involving citizens in policy development to ensure that decisions are legitimate, and reflect the broad social values of the public. We sought to bring these issues together by employing a participatory approach to elicit ethical and social values in HTA. Our primary objective was to elicit a set of ethical and social values from citizens that could be used to guide Ontario's HTA evidentiary review and appraisal process. A secondary objective was to explore the feasibility of using participatory approaches to elicit these values. A 14-person Citizens' Reference Panel on Health Technologies was established to provide input to the Ontario Health Technology Advisory Committee in developing its recommendations. A mixed methods approach was used where informed, deliberative discussions were combined with pre- and post-questionnaires, which assessed the relative importance of various ethical and social values as well as their stability over time. Over the course of five meetings, panel members progressed toward the identification of a set of core values - universal access, choice and quality care. These values were consistently prioritized as the core values that should be considered in the evaluation of health technologies and ensuing recommendations. Sustained and deliberative methods, like a citizens' panel, offer a promising approach for eliciting ethical and social values into HTA.

Suggested Citation

  • Bombard, Yvonne & Abelson, Julia & Simeonov, Dorina & Gauvin, Francois-Pierre, 2011. "Eliciting ethical and social values in health technology assessment: A participatory approach," Social Science & Medicine, Elsevier, vol. 73(1), pages 135-144, July.
  • Handle: RePEc:eee:socmed:v:73:y:2011:i:1:p:135-144

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    References listed on IDEAS

    1. De Vries, Raymond & Stanczyk, Aimee & Wall, Ian F. & Uhlmann, Rebecca & Damschroder, Laura J. & Kim, Scott Y., 2010. "Assessing the quality of democratic deliberation: A case study of public deliberation on the ethics of surrogate consent for research," Social Science & Medicine, Elsevier, vol. 70(12), pages 1896-1903, June.
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    5. Banta, David, 2003. "The development of health technology assessment," Health Policy, Elsevier, vol. 63(2), pages 121-132, February.
    6. Abelson, Julia & Miller, Fiona A. & Giacomini, Mita, 2009. "What does it mean to trust a health system?: A qualitative study of Canadian health care values," Health Policy, Elsevier, vol. 91(1), pages 63-70, June.
    7. Giacomini, Mita & Hurley, Jeremiah & Gold, Irving & Smith, Patricia & Abelson, Julia, 2004. "The policy analysis of `values talk': lessons from Canadian health reform," Health Policy, Elsevier, vol. 67(1), pages 15-24, January.
    8. Gauvin, Francois-Pierre & Abelson, Julia & Giacomini, Mita & Eyles, John & Lavis, John N., 2010. ""It all depends": Conceptualizing public involvement in the context of health technology assessment agencies," Social Science & Medicine, Elsevier, vol. 70(10), pages 1518-1526, May.
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    10. Abelson, Julia & Forest, Pierre-Gerlier & Eyles, John & Smith, Patricia & Martin, Elisabeth & Gauvin, Francois-Pierre, 2003. "Deliberations about deliberative methods: issues in the design and evaluation of public participation processes," Social Science & Medicine, Elsevier, vol. 57(2), pages 239-251, July.
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    Cited by:

    1. Peine & Moors, 2013. "Valuing Health Technology – New Value Spaces For Personal Health Systems To Support Active Ageing," Innovation Studies Utrecht (ISU) working paper series 13-02, Utrecht University, Department of Innovation Studies, revised Sep 2013.
    2. Costa -Font, Joan & Forns, Joan Rovira & Sato, Azusa, 2015. "Participatory health system priority setting: Evidence from a budget experiment," Social Science & Medicine, Elsevier, vol. 146(C), pages 182-190.
    3. Iskrov, Georgi & Miteva-Katrandzhieva, Tsonka & Stefanov, Rumen, 2012. "Challenges to orphan drugs access in Eastern Europe: The case of Bulgaria," Health Policy, Elsevier, vol. 108(1), pages 10-18.
    4. repec:spr:patien:v:10:y:2017:i:3:d:10.1007_s40271-016-0206-8 is not listed on IDEAS
    5. repec:eee:socmed:v:198:y:2018:i:c:p:27-35 is not listed on IDEAS


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