Economic resources for health care are limited and they should be distribut
ed as fairly and effectively as possible. But the basis for such a distribu
tion 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 mark
et solutions? What is the proper role of health care politicians and author
ities? In technology assessment a promising combination of value premises a
nd empirical knowledge is used in answering such questions. The aim of this
introductory article is to explore issues related to values and value conf
licts 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 me
ntal illness, diagnostic activities, treatment decisions, priority setting
as well as research and development.