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Book Forum: FORENSICS AND ETHICS   |    
Research Ethics: A Psychological Approach
ELISSA P. BENEDEK, M.D.
Am J Psychiatry 1998;155:1624-1625.
View Author and Article Information
Ann Arbor, Mich.

edited by Barbara H. Stanley, Joan E. Sieber, and Gary B. Melton. Lincoln, University of Nebraska Press, 1996, 256 pp., $35.00

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This slim volume is the product of a symposium convened by the American Psychological Association Committee for the Protection of Human Participants in Research at the University of Nebraska–Lincoln to examine the role of empirical study on ethical issues on research. At the meeting, leading psychologist-researchers reviewed recent empirical studies of 1) ethical decision-making bodies (institutional review boards), 2) privacy protection, 3) subject and experimenter bias, 4) communication in research settings, and 5) informed consent and competency. The editors note that the field has now progressed to empirical studies providing empirical data on how research is really conducted and how and whether researchers adhere to formally articulated standards with regard to the conduct of psychological research in their professional ethical code. Although this volume focuses primarily on research by psychologists, it also deals with biomedical research.

In the introduction, Dr. Sieber, Professor of Psychology at California State University, Hayward, and a senior research scholar, notes that an academic telling psychologists what is ethical conduct in research is different from a researcher knowing how to do ethical research and using that body of knowledge to conduct ethical research. She observes that a researcher must know the answers to the following questions: 1) What are the perspectives of the research participants? (that is, their expectations, concerns, and beliefs about the research); 2) How can one communicate with participants about the research in terms they understand? 3) How can one respect those privacies that are important to the participants? 4) How can one conduct the most valid research possible at the least risk to participants and society? and 5) What are the researcher’s own scientific perspectives and those of other scientists? The researcher then must demonstrate empirically that the answers to these questions are applicable. In summary, she concludes that these are all areas that can and have been studied.

In part 1, major areas of empirical research on basic issues of consent, risk-versus-benefit assessment, rapport, privacy, and confidentiality are summarized by conference participants. Of particular interest to psychiatrists is the chapter by Dr. Sieber on the subtleties of nonverbal communications that occur in the research setting and strongly affect the rapport between investigators and research participants. Although as psychiatrists/clinicians we are ever watchful with regard to the nonverbal communications of our patients, when wearing the hat of researcher, I wonder if we attend to nonverbal communication in the same way? The skills, sensitivities, and nonverbal communication so important in psychotherapy may be lost when doing research that must be squeezed into the busy clinical day. Dr. Sieber reminds the researcher of the constant attention that must be paid to the subtleties of communication in research and to their implications for the outcome of the research. She also reviews a number of empirical studies in this area. In my opinion, this chapter is particularly important for the beginning researcher.

In another chapter, Dr. Stanley and Jeannine R. Guido review research on informed consent, including voluntariness, competency, disclosure, comprehension, participants’ reactions to being informed, the decision-making progress, and public opinion regarding informed consent research and the use of deception. I personally was surprised by the amount of deception these authors report in psychological research conducted at the undergraduate level in American universities. I always thought subjects’ participation was voluntary and never imagined that they might be part of a research pool by virtue of their enrollment in an elementary psychology course. I certainly was naive, or perhaps I just read contemporary psychological research using undergraduates as research subjects with an uncritical eye. Recently I have been reviewing research on the effects of explicit pornography on college students’ attitudes toward women and sexuality. Rethinking my literature review in the light of Dr. Guido’s comments about deception, I wonder how much deception was used in the recruitment of these students regarding their informed consent, voluntariness, and knowledge of the use to which the research might be put.

The next section of the book deals with ethical issues involved in doing psychological research on special populations or in special contexts such as hospitals and prisons. It describes populations that are especially vulnerable, which include people with mental illness or mental retardation, children, the elderly, people who have been abused or neglected, those with HIV infection, criminals, the homeless, delinquent youngsters, and troubled families. As psychiatrists doing research, we must recognize that we work with populations that are particularly vulnerable in that they lack resources or autonomy and are often unable to speak for themselves. Their informed consent, while appearing voluntary, may be neither voluntary nor truly informed.

Drs. Melton and Stanley examine the ethical issues surrounding research on populations of uncertain competence to consent. Review of the empirical research in this area reveals that individuals of uncertain competence are often more capable of rational consent than has been previously supposed, particularly if a researcher makes a concerted effort to maximize autonomy. Thomas Grisso examines the way in which institutional and organizational settings may influence the degree of coercion, threat, and candor of research participants. He focuses on such diverse institutions as public schools, colleges, hospitals, and prisons and reviews the extensive literature with regard to constraints such institutions place on the voluntariness of decision making.

Finally, in a thought-provoking chapter, Michael J. Saks and Dr. Melton ask, Is it possible to legislate morality? Encouraging psychological research contributions to problems of research ethics, Drs. Melton and Saks suggest a novel solution to the problem of encouraging, supporting, and rewarding adherence to ethical principles when conducting research. First, they examine the stick approach; that is, using sanctions imposed by professional ethics boards and the courts in a punitive fashion to enforce ethical principles when conducting research. They conclude that although a few offenders might be "caught" and a few potential offenders deterred, the stick approach will not ultimately change behavior. They suggest that university departments of psychology (supported by the American Psychological Association) site-visit one another specifically for the purpose of reviewing each other’s research projects with a focus on research ethics. The site visitor would offer friendly suggestions to correct perceived ethical problems. The visitor’s assignment would be to discuss potential ethical concerns and to help solve perceived problems. Site visitors would not visit departments to formally evaluate or file charges if ethical violations were observed. They would be expected to send a report on their visit to the American Psychological Association. Dr. Melton recognizes that such a program would require salary and support for a new staff position at the American Psychological Association. He believes that attitudes and then behavior can be changed by using "social influence aimed by friendly strangers at people who are in the business of doing research." Saks and Melton conclude that this is one strategy among a potentially large number of strategies for improving ethics among researchers, and it is offered as an illustration of one quiet way to advance ethical behavior and knowledge of ethical issues in research "and begin to create an ethos in which ethical concerns are an inherent part of the research enterprise."

This was not an easy book to read. It requires concentration and a serious consideration of the ideas presented. It is a book I suspect I will continue to use, a book I certainly will recommend to young researchers and more mature research colleagues. It forces one to examine attitudes and behavior and leads to insights and changes.

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