1731-7398 On the types of assessments concerning the effectiveness of medical procedures Galewicz Włodzimierz author Uniwersytet Jagielloński, Wydział Filozoficzny, Instytut Filozofii, Zakład Badań nad Etyką Zawodową Correspondence to: Włodzimierz Galewicz w.galewicz@uj.edu.pl 28 03 2018 Tom 15, Numer 4 2017 317 324 Copyright © 2018 2018 <div id="cke_pastebin">The subject of this article is the assessment of the effectiveness of medical procedures or interventions. In its first part I compare the different meanings that the term effectiveness assumes in the context of assessing medical interventions, including the definition of the concept of consequential effectiveness, i.e. efficiency in achieving a certain objective of recognized value, distinguishing it from purely instrumental efficiency, i.e. effectiveness in achieving any goal, and from ‘cost-effectiveness’ or economic efficiency. Next, I discuss various directions of relativization that allow for, and largely assume, assessments of the effectiveness of medical interventions, primarily considering the purpose, which serves as their point of reference. In the third part, I emphasize the different character of assessments of the effectiveness of medical procedures depending on whether they relate to the final or only to the indirect purpose of a given procedure. Finally, I consider the validity of the popular opposition of effectiveness and efficiency, and egalitarian fairness or justice (equity) in relation to health care procedures.</div> 1 Miller F.G., Brody H., Chung K.C., Cosmetic surgery and the internal morality of medicine, “Cambridge Quarterly of Healthcare Ethics” 2000; 9: 353–364. 2 Tragakes E., Vienonen M., Key Issues in Rationing and Priority Setting for Health Care Services, WHO/EURO Health Services Management, New York 1998. 3 Gilbert R.E., Augood C., Gupta R., Ades A.E., Logan S., Sculpher M., van Der Meulen J.H., Screening for Down’s syndrome: effects, safety, and cost effectiveness of first and second trimester strategies, “British Medical Journal” 2001; 323: 1–6. 4 Park R.E., Fink A., Brook R.H., Physician ratings of appropriate indicators for six medical and surgical procedures, “Am. J. Public Health” 1986; 76: 766–772. 5 Mandelblatt J.S., Fryback D.G., Weinstein M.C., Assessing the effectiveness of health interventions for cost-effectiveness analysis, “Journal of General Internal Medicine” 1997; 12 (9): 551–558. doi:10.1046/j.1525-1497.1997.07107.x. 6 Haynes B., Can it work? Does it work? Is it worth it? The testing of healthcare interventions is evolving, “British Medical Journal” 1999; 319: 652–653. 7 Marley J., Efficacy, effectiveness, efficiency, “Australian Prescriber” 2000; 23: 114–151. 8 Luce B.R., Drummond M., Jönsson B., Neumann P.J., Schwartz J.S., Siebert U., S.D., EBM, HTA, and CER: Clearing the Confusion, “Milbank Q” 2010; 88 (2): 256–276. doi: 10.1111/j.1468-0009.2010.00598.x 9 Rynek Zdrowia, 19 listopada 2015 r., Eksperci: leki w iniekcjach to mniejsze koszty leczenia schizofrenii; http://www.rynekzdrowia.pl/Uslugi-medyczne/Eksperci-leki-w-iniekcje-to-mniejsze-kleszty-leczenia-schizofrenii,156900,8.html (accessed: 01.10.2017). 10 NICE (The National Institute for Health and Care Excellence), Guide to the methods of technology appraisal 2013; https://www.nice.org.uk/process/pmg9/chapter/foreword, (accessed: 01.10.2017). 11 AOTMiT (Agencja Oceny Technologii Medycznych i Taryfikacji), Wytyczne oceny technologii medycznych (HTA), AOTMiT, Warszawa 2016. 12 Muldoon M.F., Manuck S.B., Matthews K.A., Lowering cholesterol concentrations and mortality: A quantitative review of primary prevention trials, “British Medical Journal” 1990; 301 (6747): 309–314. 13 Fleming T.R., DeMets D.L., Surrogate end points in clinical trials: Are we being misled? “Ann. Mem. Med.” 1996; 125: 605–613. 14 Ross W.D., Foundations of Ethics. The Gifford Lectures, Oxford University Press, Oxford 2000. 15 Howard K.I., Mora K., Brill P.L., Martinovich, Z., Lutz W., Evaluation of psychotherapy: Efficacy, effectiveness, and patient progress, “American Psychologist” 1996; 51: 1059–1064. 16 Sassi F., Le Grand J., Archard L., Equity versus efficiency: a dilemma for the NHS : If the NHS is serious about equity it must offer guidance when principles conflict, “British Medical Journal” 2001; 323 (7316): 762–763.