Shading the Truth in Seeking Informed Consent for Research Purposes

Abstract

I want to argue for two propositions. First, I suggest that what some researchers may take to be a simple trade-off between minor violations of the truth for the sake of access to far greater truths represents a profound miscalculation with far-reaching and cumulative reverberations. Second, I submit that today's research environment, as demanding, competitive, and sometimes bewildering as it is, offers genuine scope for what Murdoch calls truth-seeking, for imagining and questioning, and for relating to facts through both truth and truthfulness; but that, in so doing, it presents hard choices with respect to methods, and, in turn, to personal integrity—not only in particular research projects but also with respect to that fragile research environment in its own right.

Using informed consent to save trust

“…Sissela Bok's early writing mobilises the risk to public trust against ‘policies of shading the truth (in deceptive psychological research), which are opposed to what must remain informed consent;’ she expresses frustration that ‘advocates of deceptive research… rarely even take into account the risk of damaging the climate of trust in which they have to operate.’10 The same concern for public trust underwrites her opposition to deceptive placebo prescription:The trust of those patients who find out they have been duped is lost, sometimes irretrievably. They may then lose confidence in physicians and in bona fide medications which they may need in the future.…”

“…First, patients who realise that doctors sometimes impose unwanted medical interventions might stop trusting doctors not to impose them, and stay away from doctors, out of fear 7 21 22. Second, a doctor's lies and deceit may undermine trust in the doctor's and officials' veracity—and advice 4 10 11. Third, imposed care, lies and other violations of real or perceived informed consent duties can antagonise patients, thereby instigating suspicion, negative feelings, low rapport and general doubt about the doctor's and officials' good will, competence and advice, with impact on adherence.…”

What a Tangled Web We Weave: Ethical and Legal Implications of Deception in Recruitment

“…Several ethical issues have been raised regarding the use of deception in research, and recommendations have been offered to guide its use and minimize its potential harms (Benham, 2008;Bok, 1995;Levine, 1982;Miller et al, 2005;Wendler and Miller, 2004). Among the concerning issues are erosion of public trust (Benham, 2008;Miller and Kaptchuk, 2008), impact on the doctor-patient relationship (Bok, 2002), and autonomy and informed consent (Benham, 2008;Bok, 1995;Dowrick et al, 2007;Hechem and Subscribe free at www.firstclinical.com © 2009 Taylor and Francis 3 Gonorazky, 2005).…”

“…Among the concerning issues are erosion of public trust (Benham, 2008;Miller and Kaptchuk, 2008), impact on the doctor-patient relationship (Bok, 2002), and autonomy and informed consent (Benham, 2008;Bok, 1995;Dowrick et al, 2007;Hechem and Subscribe free at www.firstclinical.com © 2009 Taylor and Francis 3 Gonorazky, 2005). Given the foundational biomedical ethics principle of autonomy (Beauchamp and Childress, 2001), any practice that compromises an individual's ability to choose what will and will not be done in a medical context is immediately suspect.…”

Arguing for a social work role in the promotion of ethical social research

“…In practice, not all social research involving participants is considered by some committees and researchers to be within the purview of ethical review Coercion, when seen as needless red tape and bureaucratic obstruction, may be resisted, leading to antagonism and deception (Bok 1996).…”