Psychiatric research has increased remarkably over recent decades to help in understanding the current trends and better therapeutic options for illness. On the other hand, there is also a trend toward higher rates of retraction of published papers in the recent years. Ethics is required to maintain and increase the overall quality and morality of research. Psychiatric research faces several unique ethical challenges. Ethical guidelines are very important tool of research which safeguards participants; however, there is a dearth of such guidelines in India. Ethical Issues in Psychiatric Mental Health
The present paper aims to review available ethical issues and guidelines pertaining to psychiatric research. A search was conducted on Pubmed using search terms (e.g., “ethics,” “psychiatry,” “research”). Relevant studies were selected for the review after manual screening of title/abstract. Additional sources were referred to using cross references and Google Scholar. Psychiatric research has several important ethical issues which are different from other medical disciplines. These issues are related to informed consent, confidentiality, conflict of interest, therapeutic misconception, placebo related, vulnerability, exploitation, operational challenges, among others. The current paper has made several recommendations to deal with ethical challenges commonly faced in psychiatric research. The ethical guidelines are utmost needed for Indian psychiatric research. Specific guidelines are lacking pertaining to psychiatric research. The issues and recommendations merit a further discussion and consideration.Ethical Issues in Psychiatric Mental Health Practice.
Key words: Ethics, mental health, psychiatry, research
The term “ethics” has been derived from the ancient Greek words “ethos,” which implies to understand right and wrong.[1] It refers moral standards and values that a person carries within himself.[2] Research is defined as “any systematic investigation designed to develop or contribute to generalizable knowledge.”Ethical Issues in Psychiatric Mental Health Practice.
The World Health Organization (WHO) estimates that 10% of world population is suffering from some psychiatric illness and 25% of person experience some psychiatric illness during their lifetime.[3,4] According to a review by Math and Srinivasaraju, at least 20% of population in India is suffering from some psychiatric illness.[5] Five out of ten leading cause of disability are due to mental illness, for example, depression, alcohol abuse, bipolar mood disorder, schizophrenia, and obsessive-compulsive disorder (OCD).[6] The continued suffering and disability due to mental illness calls for newer treatments and continued research into field of psychiatry.Ethical Issues in Psychiatric Mental Health Practice.
Psychiatric disorders itself carry significant stigma, myths, and biases. Causation of psychiatric disorders has varied beliefs as described by cultural psychiatrist as explanatory models of illness that includes moral model, religious model, magical or supernatural model, medical model, and psychosocial stress model.Ethical Issues in Psychiatric Mental Health Practice.
Considering various issues involved in psychiatric disorders and research, ethics plays crucial role in protecting rights of persons with mental illness and simultaneously safeguarding the interest of researchers. Ethical guidelines in research help maintain transparency and accountability during research. Therefore, various ethical guidelines have been put forward by national and international organizations for different groups of researchers.Ethical Issues in Psychiatric Mental Health Practice.
Historically, ethical abuse in human research was noticed in experiments conducted by Nazi doctors on convicts, following which the first international standard for ethical conduct of research was framed, the Nuremberg Code in 1947.[8,9] It was based on ten principles focusing on voluntary consent, right to withdraw from the study, and prohibited studies causing harm to patients. TEthical Issues in Psychiatric Mental Health Practice.he World Medical Association also adopted a set of guidelines known as the Declaration of Helsinki which consisted 32 principles, which focused on informed consent, confidentiality, vulnerable population, and requirement of a research protocol stating scientific rationale of the study which need to be reviewed by the Ethics Committee.[10] Later on, following infamous Syphilis study at Tuskegee in 1972, the National Commission for the
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