The inclusion of new health technologies in the benefit basket of the public healthcare system is the result of an assessment process characterised by uncertainty. In this regard, ethically controversial health technologies harbour additional uncertainty, for before regulators make reimbursement decisions, they need to be well aware of the potential effects of a new technology on the ethical values of a society and its moral implications.
Against this background, this comparative dissertation inquires to what extent ethical concerns are taken into account in reimbursement and coverage decisions in Germany, Italy and the United Kingdom, and whether the state obligation of neutrality shall be respected in this process. The choice of the principle of ethical neutrality as a normative criterion for the analysis is explained and justified from a legal theoretical and constitutional perspective. In doing so, the thesis aims at clarifying whether this principle has a more limited scope in a field of state action characterised by the exercise of wide legislative discretion, such as the implementation of the social right to healthcare.
