Theories of technological development and HTA

Development and diffusion of technologies during the modern era has been interpreted in different ways. For example, Jacques Ellul (1912-1994), Lewis Mumford (1895-1990) and, in recent years, Langdon Winner argue for the so-called technological determinism, for which both the development and the widespread use of technologies fall outside the conscious control of the man: they would follow an immanent logic and could be slowed or accelerated outside, but they could not be guided. Instead, other authors argue for the thesis, according to which they would result from economic forces, i.e. exogenous factors. Moore recent theories (David S. Landes, Doris MacKenzie, David Noble and Thomas P. Hughes) reject all deterministic approaches, both those who consider technological development as a simple reflection of economic forces that those who consider technological development as a result of endogenous factors. According to the new models, technological development would be the result of both endogenous and exogenous factors. For what concerns the healthcare context, some authors (for example, Lisa Cosmi) interpret the processes of technological development as a phenomenon that would result from exogenous factors, others as a phenomenon that would result from endogenous factors. The paper will reflect on the overall significance of the “assessment” of health technologies in relation to the main theories of technological development.