International Journal of Technology Assessment in Health Care, 23:1 (2007), 9–16. Copyright c  2007 Cambridge University Press. Printed in the U.S.A. Mapping the integration of social and ethical issues in health technology assessment Pascale Lehoux Bryn Williams-Jones University of Montreal Background: Since its inception, the field of health technology assessment (HTA) has stressed the need for consideration of ethical and social issues. However, few concepts or analytic tools have been developed, and because of the complexity of the endeavor and a lack of integration of work already produced, such concepts remain difficult to apply in HTA. Objectives: Through a descriptive “map” of concepts, tools, and processes, we summarize the most tangible efforts on the part of HTA producers to address social and ethical issues. Methods: A literature review and content analysis of HTA reports in the Centre for Reviews and Dissemination database enables a synthesis of the reflections on, initiatives around, and gaps in knowledge related to the integration of social and ethical issues in HTA. Results: We examine: (i) the aim of integrating ethical and social issues in HTA, (ii) the theoretical approaches used, (iii) the methods and processes applied, and (iv) the implications for HTA producers. We highlight two levels at which social and ethical issues can be considered: throughout the production process of HTA reports and as part of the organizational structure of HTA agencies. Conclusions: Given the profound societal changes that occur in relation to healthcare technology development, HTA producers have a responsibility to inform and enlighten technology-related public and policy debates. Fulfilling this role, though, requires that socioethical dimensions of technology and HTA are made explicit. Keywords: Healthtechnology assessment, HTA, Ethics, Social issues, Values, Policy making AIM: WHY SHOULD HEALTH TECHNOLOGY ASSESSMENT INTEGRATE SOCIAL AND ETHICAL ISSUES? The initial description of the purpose of health technology as- sessment (HTA), proposed by the U.S. Office of Technology P. Lehoux, a scholar of health administration and HTA, holds a Canada Research Chair on Innovations in Health (2005-10); two sections of this study partly draw from her book The Problem of Health Technology. Policy Implications for Modern Health Care Systems. Williams-Jones, a bioethics scholar working on ethics, technology, and health care, was supported by grants from the Canadian Institutes of Health Research and the Faculty of Medicine, University of Montreal. Assessment in the early 1970s, has been adopted internation- ally and remains almost unchanged. According to Banta and Perry, [HTA] enlarges the evaluation process to encompass not only the clinical consequences, but also the economic, ethical, and other social implications of the diffusion and use of a specific procedure or technique on medical practice.... [I]ts aim is to provide facts as a basis for not only clinical decision making, but also for policy making in health care as a societal endeavor (3). Yet if there is a wide consensus about such an inclusive mission statement, in practice there has been remarkably 9