False hopes and best data: consent to research and the therapeutic misconception
Department of Psychiatry
Medical Subject Headings
Clinical Trials as Topic; *Comprehension; Control Groups; Disclosure; Double-Blind Method; Humans; *Informed Consent; Mental Disorders; Mentally Ill Persons; Nontherapeutic Human Experimentation; *Patient Education as Topic; Research; *Research Subjects; Risk; Risk Assessment; Therapeutic Human Experimentation
Behavior and Behavior Mechanisms | Health Services Research | Psychiatry | Psychiatry and Psychology
Using examples from psychiatric research, the authors explore the ethical dilemma of the "therapeutic misconception," where, despite explanation, patient-subjects believe that research protocols are designed to benefit them directly rather than to test or compare treatment methods. Even potential subjects who demonstrate an understanding of randomization, double-blinded studies, and the use of placebos frequently persist in a belief that they purposely will receive the treatment most likely to benefit them. They expect the standards of personal care that characterize the therapeutic relationship to carry over to the clinical trial, failing to understand that the need for valid research results makes this impossible. Appelbaum et al. suggest ways in which patients can be made to understand the differences between treatment and research, and the disadvantages and advantages of participation in the latter.
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Citation: Hastings Cent Rep. 1987 Apr;17(2):20-4.