Health technology assessment (HTA) consists of the systematic study of the
consequences of the introduction or continued use of the technology in a pa
rticular context, with the explicit objective to arrive at a judgment of th
e value or merit of the technology. Ideally, it is aimed at assessing all a
spects of a given technology or group of technologies, including non-techni
cal, e.g. socio-ethical, aspects. However, methods for assessing socio-ethi
cal implications of health technology are relatively undeveloped and few me
chanisms exist to take action based on the results of such evaluations. Sti
ll, the examples of cochlear inplants (CI) and other cases illustrate that
HTA is not a matter of merely collecting the facts about a technology. The
facts must be plausible and relevant from a particular framework, which is
not always shared by different groups. It is here that socio-ethical aspect
s are encountered. If health technology assessment aims to enhance the acco
untability of the decision making process regarding funding and use of heal
th technology, it is a major challenge to assessors of health technologies
to deal adequately with existing value pluralism. In this respect interacti
ve evaluation may have something to offer.