International Journal of Technology Assessment in Health Care, 00:0 (2014), 1–6. c  Cambridge University Press 2014 doi:10.1017/S0266462314000014 Methods ETHICS EXPERTISE FOR HEALTH TECHNOLOGY ASSESSMENT: A CANADIAN NATIONAL SURVEY Kenneth Bond Institute of Health Economics Mark Oremus Department of Clinical Epidemiology and Biostatistics, McMaster University Katherine M. Duthie Fraser Health Ethics Services Glenn G. Griener School of Public Health and Department of Philosophy, University of Alberta Objectives: The aim of this study was to identify individuals with expertise in ethics analysis in Canada, who might contribute to health technology assessment (HTA); to gauge these individuals’ familiarity with, and experience participating in, the production of HTA. Methods: A contact list was developed using the Canadian Bioethics Society membership list and faculty listings of Canadian universities, bioethics centers, and health agencies. An eighteen-question email survey was distributed to potential respondents to collect data on demographic information, education and work experience in applied ethics, and involvement in HTA. Results: The survey response rate was 52.8 percent (350/663). Respondents worked primarily in academic institutions (50.4 percent) or hospitals (15.4 percent). Many respondents (83.1 percent) had education, formal training, or work-related experience in practical ethics related to health care, with many having a doctorate (34.5 percent) or master’s degree (19.0 percent). One quarter (24.5 percent; n = 87) of respondents indicated they had been involved in an analysis of ethical issues for HTA. Almost two-thirds (65.4 percent; n = 165) of those who had not previously participated in ethics analysis believed they might usefully contribute to an analysis of ethical issues in HTA. Experts who have conducted ethics analysis in HTA had more than twice the odds of having education and training in ethics and a PhD than those who might contribute to ethics analysis. Conclusion: Many people have contributed to ethics analysis in HTA in Canada, and more are willing to do so. Given the absence of a reliable credential for ethics expertise, HTA producers should exercise caution when enlisting ethics experts. Keywords: Ethics, Health technology assessment, Health policy Health technology assessment (HTA) is a form of multidisci- plinary research that typically consists of the systematic ex- amination of the safety, clinical efficacy and effectiveness, and cost-effectiveness of a technology, but that may also include the organizational implications, social consequences, and legal and ethical implications of its adoption and implementation (1;2). Although the completeness and rigor of HTAs vary in practice, the purpose of all HTAs is to inform policy decisions regard- ing the efficient, appropriate, and fair allocation of healthcare Partial financial support for this project was provided through collaborative funding from the Canadian HTA Exchange and the Canadian Agency for Drugs and Technologies in Health. Financial support and research assistance were provided by the Institute of Health Economics, with funding from Alberta Health. The authors thank Amanda Harrigan for her assistance in assembling and maintaining the contact list. The authors also thank the following members of the Canadian HTA Exchange for their support and collaboration in this project: Stephen Bornstein, Newfoundland and Labrador Centre for Applied Health Research, St. John’s, NL; Nina Buscemi, Alberta Health, Edmonton, AB; Ron Goeree, Programs for Assessment of Technology in Health (PATH) Research Institute, McMaster University, Hamilton, ON; Christa Harstall, Institute of Health Economics, Edmonton, AB; Don Juzwishin, Alberta Health Services, Edmonton, AB; Murray Krahn, Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, ON; Janet Martin, High Impact Technology Evaluation Centre, London Health Sciences Centre, London, ON; David Moher, Ottawa Hospital Research Institute, Ottawa, ON. resources. Although there is a consensus that ethics analysis is important in HTA, there are questions about how to appropri- ately address the ethical issues that arise both in the conduct of an HTA and with respect to the technology being evaluated (3). Most large HTA agencies (both producers and users) declare they include ethical issues in the scope of their evaluative criteria for assessment (4). Nevertheless, researchers in countries with developed HTA programs have shown a discrepancy between these declarations and the presence of meaningful identification and analysis of ethical issues in HTA reports (3–6). Reasons for this discrepancy have included the difficulty of defining ethics in the context of HTA (7), the problem of generalizing the findings of an ethics analysis (7), lack of clear analytic methods (8), controversy regarding who has the authority to offer ethical expertise (7), and agencies’ constraints on time and resources that prevent them from taking on the “additional” task of ethics analysis (9). Some researchers (4–6) have proposed that the recogni- tion of relevant expertise in ethics analysis and the continuing development of methods for analyzing ethical issues are cru- cial to conducting ethics analyses in HTAs more consistently, systematically, and rigorously than is done currently. However, 1