Research Ethics Issues in Geriatric Psychiatry

Dunn, Laura B.; Misra, Sahana

doi:10.1016/j.psc.2009.03.007

Cited by 23 publications

(31 citation statements)

References 63 publications

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“…Of the 80 articles, 16 were essay-type articles 16,20,23,27,30,33,37,42,64,65,67,68,71,72,81,91 ; 7 were surveys 18,19,46,47,73,75,85 ; and 57 were research articles consisting of case studies and case reports, follow-up studies, cross-sectional studies, case-control and cohort studies, randomized trials, and systematic reviews. 13–15,17,21,22,24–26,28,29,31,32,34–36,38–41,43–45,48–63,66,69,70,74,76–80,82–84,86–90,92 The studies reviewed were from a variety of international settings: United States (n = 33); United Kingdom (n = 7); France (n = 5); the Netherlands (n = 5); Spain (n = 3); and Canada, Sweden, Finland, Germany, Switzerland, Turkey, Hong Kong, Scotland, Norway, Italy, South Africa, Israel, Korea, Austria, and Nigeria.…”

Section: Resultsmentioning

confidence: 99%

“…Decision-making capacity, 1 of the principle pillars of valid informed consent, has 4 essential domains: understanding relevant information, appreciating and applying the information to one’s personal needs and circumstances, rational reasoning, and communicating a clear and consistent choice. 30 Even though the MMSE and MacCAT for Clinical Research were the most studied capacity assessment tools, investigators in few studies reported using them in everyday practice. The tools were time-consuming to use and insufficient to determine the degree to which patients possess the capacity to provide valid consent.…”

Section: Discussionmentioning

confidence: 99%

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Informed consent in dental care and research for the older adult population

Mukherjee¹,

Livinski²,

Millum³

et al. 2017

The Journal of the American Dental Association

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Background Ethics in health care and research is based on the fundamental principle of informed consent. However, informed consent in geriatric dentistry is not well documented. Poor health, cognitive decline, and the passive nature of many geriatric patients complicate this issue. Methods The authors completed this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors searched the MEDLINE PubMed, Web of Science, PsycINFO, and Cochrane Library databases. The authors included studies if they involved participants 65 years or older and discussed topics related to informed consent beyond obtaining consent for health care. The authors explored informed consent issues in dentistry and other biomedical care and research. Results The authors included 80 full-text articles on the basis of the inclusion criteria. Of these studies, 33 were conducted in the United States, 30 addressed consent issues in patients with cognitive impairment, 29 were conducted in patients with medical issues, and only 3 involved consent related to dental care or research. Conclusions Informed consent is a neglected topic in geriatric dental care and research. Substantial knowledge gaps exist between the understanding and implementation of consent procedures. Additional research in this area could help address contemporary consent issues typically encountered by dental practitioners and to increase active participation from the geriatric population in dental care and research. Practical Implications This review is the first attempt, to the authors’ knowledge, to identify informed consent issues comprehensively in geriatric dentistry. There is limited information in the informed consent literature covering key concepts applicable to geriatric dentistry. Addressing these gaps could assist dental health care professionals in managing complex ethical issues associated with geriatric dental patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Informed consent in dental care and research for the older adult population

Mukherjee¹,

Livinski²,

Millum³

et al. 2017

The Journal of the American Dental Association

View full text Add to dashboard Cite

show abstract

“…Writing on research ethics in geriatric psychiatry, Dunn and Misra [34] warn that, unless work is done to clarify the issues surrounding proxy consent and incapacitated persons, 'deleterious effects on research can result' which includes research bans and over-protection as well as inaccurate weighing of risks and benefits (p. 395). These authors' concerns mirror those of Fins' for the case of patients with severe DOC.…”

Section: The Role Of Surrogatesmentioning

confidence: 99%

Where angels fear to tread: Proxy consent and novel technologies

Lanoix

2010

Brain Injury

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“…36 Indeed, concerns have persisted for decades regarding the ethical acceptability of including people with different illnesses or have characteristics that may make them especially vulnerable in the context of human studies. 17–19 …”

Section: Introductionmentioning

confidence: 99%

Giving voice to study volunteers: Comparing views of mentally ill, physically ill, and healthy protocol participants on ethical aspects of clinical research

Roberts

Kim

2014

Journal of Psychiatric Research

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Motivation Ethical controversy surrounds clinical research involving seriously ill participants. While many stakeholders have opinions, the extent to which protocol volunteers themselves see human research as ethically acceptable has not been documented. To address this gap of knowledge, authors sought to assess views of healthy and ill clinical research volunteers regarding the ethical acceptability of human studies involving individuals who are ill or are potentially vulnerable. Methods Surveys and semi-structured interviews were used to query clinical research protocol participants and a comparison group of healthy individuals. A total of 179 respondents participated in this study: 150 in protocols (60 mentally ill, 43 physically ill, and 47 healthy clinical research protocol participants) and 29 healthy individuals not enrolled in protocols. Main outcome measures included responses regarding ethical acceptability of clinical research when it presents significant burdens and risks, involves people with serious mental and physical illness, or enrolls people with other potential vulnerabilities in the research situation. Results Respondents expressed decreasing levels of acceptance of participation in research that posed burdens of increasing severity. Participation in protocols with possibly life-threatening consequences was perceived as least acceptable (mean = 1.82, sd = 1.29). Research on serious illnesses, including HIV, cancer, schizophrenia, depression, and post-traumatic stress disorder, was seen as ethically acceptable across respondent groups (range of means = [4.0, 4.7]). Mentally ill volunteers expressed levels of ethical acceptability for physical illness research and mental illness research as acceptable and similar, while physically ill volunteers expressed greater ethical acceptability for physical illness research than for mental illness research. Mentally ill, physically ill, and healthy participants expressed neutral to favorable perspectives regarding the ethical acceptability of clinical research participation by potentially vulnerable subpopulations (difference in acceptability perceived by mentally ill - healthy=−0.04, CI [−0.46, 0.39]; physically ill – healthy= −0.13, CI [−0.62, −.36]). Conclusions Clinical research volunteers and healthy clinical research-“naive” individuals view studies involving ill people as ethically acceptable, and their responses reflect concern regarding research that poses considerable burdens and risks and research involving vulnerable subpopulations. Physically ill research volunteers may be more willing to see burdensome and risky research as acceptable. Mentally ill research volunteers and healthy individuals expressed similar perspectives in this study, helping to dispel a misconception that those with mental illness should be presumed to hold disparate views.

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Research Ethics Issues in Geriatric Psychiatry

Cited by 23 publications

References 63 publications

Informed consent in dental care and research for the older adult population

Informed consent in dental care and research for the older adult population

Where angels fear to tread: Proxy consent and novel technologies

Giving voice to study volunteers: Comparing views of mentally ill, physically ill, and healthy protocol participants on ethical aspects of clinical research

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