Why is therapeutic misconception so prevalent?

UMMS Affiliation

Department of Psychiatry; Systems and Psychosocial Advances Research Center

Publication Date


Document Type



Bioethics and Medical Ethics | Health Services Research | Law and Psychology | Psychiatry | Psychiatry and Psychology


Therapeutic misconception (TM)-when clinical research participants fail to adequately grasp the difference between participating in a clinical trial and receiving ordinary clinical care-has long been recognized as a significant problem in consent to clinical trials. We suggest that TM does not primarily reflect inadequate disclosure or participants' incompetence. Instead, TM arises from divergent primary cognitive frames. The researchers' frame places the clinical trial in the context of scientific designs for assessing intervention efficacy. In contrast, most participants have a cognitive frame that is personal and focused primarily on their medical problems. To illustrate this, we draw on interview material from both clinical researchers and participants in clinical trials. We suggest that reducing TM requires encouraging subjects to adjust their frame, not just add information to their existing frame. What is necessary is a scientific reframing of participation in a clinical trial.


therapeutic misconception, informed consent, clinical trials, research ethics

DOI of Published Version



Camb Q Healthc Ethics. 2015 Apr;24(2):231-41. doi: 10.1017/S096318011400053X. Link to article on publisher's site

Journal/Book/Conference Title

Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees

Related Resources

Link to Article in PubMed