Values and technology assessment in psychiatry.

T Nilstun, C G Westrin, S Thelander, L Jacobsson
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Abstract

Economic resources for health care are limited and they should be distributed as fairly and effectively as possible. But the basis for such a distribution is far from clear. What interests are involved? What kind of provision of care is most efficient? How far should the distribution be left to market solutions? What is the proper role of health care politicians and authorities? In technology assessment a promising combination of value premises and empirical knowledge is used in answering such questions. The aim of this introductory article is to explore issues related to values and value conflicts that have implications for technology assessment. Ethical principles are discussed and related to problematic issues in mental health care such as the absence of psychiatry, the abuse of psychiatry, the definition of mental illness, diagnostic activities, treatment decisions, priority setting as well as research and development.

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精神病学的价值与技术评估。
用于保健的经济资源是有限的,应尽可能公平和有效地加以分配。但这种分布的基础还远不清楚。涉及什么利益?什么样的医疗服务最有效?分销应该在多大程度上由市场来解决?卫生保健政治家和当局的适当角色是什么?在技术评估中,价值前提和经验知识的有效结合被用于回答这些问题。这篇介绍性文章的目的是探讨与价值和价值冲突相关的问题,这些问题对技术评估有影响。伦理原则被讨论并与精神卫生保健中的问题相关,如精神病学的缺失、精神病学的滥用、精神疾病的定义、诊断活动、治疗决定、优先事项的确定以及研究和发展。
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