Book contents
- Frontmatter
- Contents
- Acknowledgments
- About the authors
- 1 Introduction
- 2 New problems, new ethics: challenging the value structure of health care
- 3 Conflict and synthesis: the comparative anatomy of ethical and clinical decision making
- 4 Solving clinical puzzles: strategies for organizing mental health ethics rounds
- CASES IN MENTAL HEALTH ETHICS
- I Informed consent, competency, and involuntary treatment
- II Confidentiality
- III Truth-telling
- IV Managing difficult patients
- V Parents and children
- VI Religion and mental health treatment
- VII Allocation of resources
- VIII Research
- IX Mental health and medical illness
- X Mental health and criminal justice
- Bibliography
- Index
VIII - Research
from CASES IN MENTAL HEALTH ETHICS
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- Acknowledgments
- About the authors
- 1 Introduction
- 2 New problems, new ethics: challenging the value structure of health care
- 3 Conflict and synthesis: the comparative anatomy of ethical and clinical decision making
- 4 Solving clinical puzzles: strategies for organizing mental health ethics rounds
- CASES IN MENTAL HEALTH ETHICS
- I Informed consent, competency, and involuntary treatment
- II Confidentiality
- III Truth-telling
- IV Managing difficult patients
- V Parents and children
- VI Religion and mental health treatment
- VII Allocation of resources
- VIII Research
- IX Mental health and medical illness
- X Mental health and criminal justice
- Bibliography
- Index
Summary
WILLING SUBJECTS, QUESTIONABLE COMPETENCE
How should staff deal with patients willing to take part in low-risk experiments, but whose competence to consent is in doubt?
Apsychologist is caring for an elderly woman inpatient with severe memory impairment, from whom he would like to obtain consent to do a diagnostic research protocol. The protocol itself is non-invasive and includes only sleep studies, neuropsychological testing, and EEG with evoked potentials. The patient appears to understand each component of the research, as well as the requests in general that she participate in research. However, she does not retain memory of any of this for more than a few minutes. It is not clear whether, when all of it is explained together, she retains the memory of the first part before the explanation of the last part is completed. Nonetheless she has been willing to go along. There is no family involved with her, but she does have a close friend. She has never been formally adjudicated incompetent. She was admitted to the hospital on a voluntary basis.
Questions
(1) How does the patient's memory impairment affect the giving of informed consent in this case?
(2) How meaningful ethically is the value of obtaining informed consent here?
(3) If you think it has little value, have you an alternative way of bringing patients like this into experiments?
(4) In this case, does the low risk of the experiment make a difference in the decision to admit her to the test?
[…]
- Type
- Chapter
- Information
- Divided Staffs, Divided SelvesA Case Approach to Mental Health Ethics, pp. 115 - 120Publisher: Cambridge University PressPrint publication year: 1987