价值论法在卫生技术伦理学评估中的应用与思考  

Application and reflection of axiology in ethical assessment of health technology

作　　者：王俊伟 洪冬旎 尹洁 戎春宇 王云梦 王宝悦 周萍[1] WANG Junwei;HONG Dongni;YIN Jie;RONG Chunyu;WANG Yunmeng;WANG Baoyue;ZHOU Ping(School of Public Health,Fudan University,NHC Key Laboratory of Health Technology Assessment,Shanghai Research Center for Governance of Emerging Technologies in medicine and public health,Shanghai 200032,China;School of Philosophy,Fudan University,Shanghai 200433,China)

机构地区：[1]复旦大学公共卫生学院,国家卫生健康委卫生技术评估重点实验室,上海医学与公共卫生新兴技术治理研究中心,上海200032 [2]复旦大学哲学学院,上海200433

出　　处：《健康发展与政策研究》2024年第6期474-481,共8页Health Development and Policy Research

基　　金：国家社会科学基金重大项目(23&ZD188);上海市加强公共卫生体系建设三年行动计划(2023—2025)重点学科建设项目(GWVI-11.1-49)。

摘　　要：伦理学评估是卫生技术评估(health technology assessment,HTA)的重要组成部分,随着HTA的发展产生了许多伦理学评估的方法,其中“价值论法”可以有效地将伦理学方法与工具整合到HTA中,做出更好的决策。本文就国际上已经应用的价值论方法和指南,包括苏格拉底式法、HTA核心模型、瑞典、西班牙、法国HTA指南,进行描述与讨论。价值论法可通过1组与卫生技术相关的伦理问题对该卫生技术进行分析,引起伦理反思,探讨使用该技术后的伦理后果,在权衡后由决策者制定是否使用该技术的决策。此外,本文将上述方法或指南中的卫生技术相关伦理问题进行整理,以助力形成适合我国国情的伦理问题清单,构建具有我国特色的价值论方法指南,促进卫生技术的健康发展。Ethical assessment is an essential component of health technology assessment(HTA).With the development of HTA,numerous methods for ethical assessment have emerged.Among them,axiology effectively integrates ethical methods and tools into HTA,facilitating better decision-making.This article describes and discusses the methods of axiology and guidelines that have been applied internationally,including the Socratic method,the HTA core model,and the ethical assessment guidelines for health technologies in Sweden,Spain,and France.Axiology analyzes health technologies through a set of ethical questions.It provokes ethical reflection,explores the ethical consequences of using the technology,and guides decision-makers in making decisions regarding using or adopting the technology after they weigh the pros and cons.Moreover,this paper systematically organizes the ethics-related issues of health technologies from the aforementioned methods and guidelines,aiming to develop an ethics checklist that is tailored to the national context of China.It also seeks to construct a distinctive axiological method guideline that reflects the unique characteristics of China,thereby promoting the healthy development of health technologies.

关 键 词：卫生技术评估 伦理学 价值论 卫生决策 

分 类 号：R19[医药卫生—卫生事业管理]