L6: ETHICAL ISSUES IN CLINICAL PSYCHOLOGY

Question 1

CORE PRINCIPLES

Answer 1

Protecting the rights, dignity and welfare of research participants
Central principles: IC, minimisation of harm, privacy and confidentiality

Question 2

GENERAL ISSUES

Answer 2

Ethics is a methodological issue- procedural decisions have EI, poorly design can be considered unethical
Ethical consideration require methodological trade-offs
Arise from viewing participants as objects or ‘subjects’- more about a partnership

Question 3

INFORMED CONSENT

Answer 3

Participants need to understand what they are going to be asked to do
Consider competence to provide consent - try provide info in different ways
Some studies require not being aware of hypotheses- withhold info, false info
An entire situation might be contrived
Freedom of choice: consent should be voluntary, without direct or indirect pressure to take part, no implicit or explicit coercion

Question 4

INFORMED CONSENT: FOC

Answer 4

Influence of FOC in clinical settings
Fear that refusal may result in withdrawal of treatment or care
Limited resources might make experimental therapy appealing - coercive for patients in long waiting lists
Offering large financial incentives to unwaged participants with LT MH conditions

Question 5

STANDARDISED PROCEDURES FOR CONSENT

Answer 5

Participant info sheet: description, risk benefits, ETW, no jargon
Consent Form: key features, signature of participant and research

Question 6

HARMS AND BENEFITS

Answer 6

Research should not harm P
May expose themselves to potential harm for good of humanity
Necessary to test medical procedure or medicine
Social risk- research on difference between ethnic or cultural groups

Question 7

DIRECT HARM

Answer 7

Clinical research may ask participants about difficult past experiences or remembering traumatic events
Could cause distress, embarrassment, new problems
May require suspension/termination of data collection
Involve sufficient debrief

Question 8

RANDOMISED DESIGN

Answer 8

Randomly allocate to EG and control group

Question 9

INDIRECT HARM: CLINICAL TRIALS

Answer 9

Withholding benefit in RCT
RCT involve random assignment
As people are presenting with a health complaint, there can be a conflict between clinical vs scientist perspectives
CT possible where there’s equipoise
Specified treatment rather than a clinical judgement
Narrow inclusion criteria, exclude patients after assessment, leaving them feeling invalidated
Randomisation deprives people of choice- are preference trials so they can choose
Client is passive- should be referred for help at termination
Wait list control- given treatment after trial

Question 10

PRIVAY AND CONFIDENTIALITY

Answer 10

Privacy- have right to not provide info to researcher
Confidentiality- right to withhold info from third parties
Anonymity
clinical case study material- case reports could identify participants if a clinician works in a known clinic, contextual details can be changed
Specify who will has access to data

Question 11

COST BENEFIT ANALYSIS

Answer 11

Risks vs benefits
Benefits to participant vs humanity
Greater risk requires stronger safeguards

Question 12

NHS RESEARCH ETHICS SERVICE

Answer 12

Transparency and help with clinical research
Range of backgrounds for balanced perspectives (doctors, lay members, lawyers)

Question 13

BPS CODE OF ETHICS AND CONDUCT

Answer 13

Respect
Competence
Responsibility
integrity