Debating the Desirability of New Biomedical Technologies: Lessons from the Introduction of Breast Cancer Screening in the Netherlands.

Health technology assessment (HTA) was developed in the 1970s and 1980s to facilitate decision making on the desirability of new biomedical technologies. Since then, many of the standard tools and methods of HTA have been criticized for their implicit normativity. At the same time research into the...

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Publicado en:Health Care Analysis Vol. 20; no. 1; pp. 84 - 103
Autor principal: Boenink, Marianne
Formato: Artículo
Publicado: Springer Nature Mar2012
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Acceso en línea:Ver este registro en EBSCOhost
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        10.1007/s10728-011-0173-0
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        atl: Debating the Desirability of New Biomedical Technologies: Lessons from the Introduction of Breast Cancer Screening in the Netherlands.
      aug:
        au: Boenink, Marianne
        affil: Department of Philosophy, Faculty of Behavioural Sciences, University of Twente, 7500 AE Enschede The Netherlands
      su:
        Netherlands
        Cancer
        Debate
        Ethics
        Technology
        Values (Ethics)
        Medical screening evaluation
        Biomedical engineering
        Breast tumors
      sug:
        subj:
          Cancer
          Debate
          Ethics
          Technology
          Values (Ethics)
          Netherlands
          All Other Miscellaneous Ambulatory Health Care Services
          Medical screening evaluation
          Biomedical engineering
          Breast tumors
      keyword:
        Breast cancer screening
        Evidence
        Health technology assessment
        Instrumental view of technology
        Mammography
        Methods
        Neutrality
        Values
        Breast cancer screening
        Evidence
        Health technology assessment
        Instrumental view of technology
        Mammography
        Methods
        Neutrality
        Values
      ab: Health technology assessment (HTA) was developed in the 1970s and 1980s to facilitate decision making on the desirability of new biomedical technologies. Since then, many of the standard tools and methods of HTA have been criticized for their implicit normativity. At the same time research into the character of technology in practice has motivated philosophers, sociologists and anthropologists to criticize the traditional view of technology as a neutral instrument designed to perform a specific function. Such research suggests that the tools and methods of more traditional forms of HTA are often inspired by an 'instrumentalist' conception of technology that does not fit the way technology actually works. This paper explores this hypothesis for a specific case: the assessments and deliberations leading to the introduction of breast cancer screening in the Netherlands. After reconstructing this history of HTA 'in the making' the stepwise model of HTA that emerged during the process is discussed. This model was rooted indeed in an instrumentalist conception of technology. However, a more detailed reconstruction of several episodes from this history reveals how the actors already experienced the inadequacy of some of the instrumentalist presuppositions. The historical case thus shows how an instrumentalist conception of technology may result in implicit normative effects. The paper concludes that an instrumentalist view of technology is not a good starting point for HTA and briefly suggests how the fit between HTA methods and the actual character of technology in practice might be improved.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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