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Ethics in Psychiatric Research: A Resource Manual for Human Subjects Protection Edited by Harold Pincus, Jeffrey Lieberman & Sandy Ferris. Washington, DC: American Psychiatric Association. 1999. 341 pp. US$75.00 (hb). ISBN 0-89042-281-8

Published online by Cambridge University Press:  02 January 2018

Sidney Bloch*
Affiliation:
Psychiatry Department, University of Melbourne, St Vincent's Hospital, Melbourne, Australia 3065
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Abstract

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Copyright © 2000 The Royal College of Psychiatrists 

The American Psychiatric Association (APA) is to be commended on producing this volume which is, as the title suggests, a manual for researchers in psychiatry. The APA's Committee on Research on Psychiatric Treatments took the wise step of focusing on the ethical dimension of psychiatric research after consulting with the research community and lay advocacy organisations. The National Institute of Mental Health has also played a major role in the manual's development.

The book is very much a practical resource although it does not assume a regulatory function. Rather, it reflects the considered judgments of the contributors. They comprise a distinguished group. The 10 chapters are, therefore, of a uniformly high standard.

After a helpful historical context, the chapters that follow deal with various facets of the research enterprise or different types of research. We are invited to consider crucial subjects such as informed consent, surrogate decision-making and advance directives, the particular difficulties of conducting medication-free research and that requiring invasive procedures, special pressures that arise in conducting research in children and adolescents, the role of the family when one of its members is a research subject, and the tricky theme of ensuring appropriate clinical care during the application of a research protocol. These are all salient topics for researchers in psychiatry and merit careful perusal.

Again, typical of a manual, the authors have introduced a range of appendices to complement their own views. This documentation is particularly illuminating and serves well to alert the psychiatric researcher to potential ethical snags and pitfalls.

Indeed, it is useful to have such documents as the Declaration of Helsinki, the Nuremberg statement and the National Institutes of Health's policy on consent in research involving impaired subjects. With one or two exceptions, the appendices are USA-based, as indeed is the book as a whole. While many of the topics discussed have universal relevance, the fact is that the manual has been prepared by American researchers to meet their needs rather than those of an international audience. Notwithstanding, much can be gleaned from the volume that is of interest and relevance to psychiatric researchers wherever they work. In the absence of any competing texts, this manual is the most comprehensive and informative so far published. We may entertain the hope that other psychiatric bodies in other countries will be spurred to prepare similar volumes to take local conditions into account. This is already happening with, for instance, a comparable manual soon to appear in Australia under the aegis of the National Health and Medical Research Council. The Australian volume has been designed for researchers in biomedicine generally, although it will contain material pertinent to research in psychiatry.

Given the horrors of the Nazi medical crimes and the Nuremberg statement that followed in 1946, it has taken an enormously long time for the research community to acknowledge and examine systematically the ethical parameters of conducting research on human subjects. In a psychiatric context, this manual is in one sense the culmination of a range of developments over half a century. Its arrival is, therefore, to be celebrated.

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