Chapter 2. The fact/value dichotomy

This chapter is focused on the so-called “fact/value dichotomy”. In the current practice of HTA, value judgments are often considered external to HTA or separate from it and are addressed by experts (in ethics) and decision makers after the “real” HTA is finished. In other words, facts and values seem to be two completely different “substances” that come from two completely different sources. Is this dichotomy attainable? 2) is it desirable? This chapter will argue that a strict fact-value distinction is not so easy to maintain, based on insights from Philosophy and HTA practice. Key messages of this chapter: HTA cannot be considered a matter of collecting the facts about a certain health technology, but rather “a matter of collecting facts that are considered plausibly associated with the use of the technology, relevant, and amenable to accepted methods of scientific inquiry”.