False Hopes and Best Data: Consent to Research and the Therapeutic Misconception

TLDR

The authors examine the therapeutic misconception in psychiatric research, noting that patients often mistakenly believe trials are designed to benefit them personally, despite understanding randomization, blinding, and placebos. The study aims to propose strategies to clarify the distinction between treatment and research and to outline the pros and cons of participation. The authors recommend specific educational interventions to help patients recognize the differences between treatment and research and to weigh the benefits and risks of participation. Reference: Appelbaum et al.

Abstract

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.