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The Call of the Sirens: Navigating the Ethics of Medication-Free Research in Schizophrenia

The Call of the Sirens: Navigating the Ethics of Medication-Free Research in Schizophrenia Abstract IN THE Odyssey, Odysseus directs his men to tie him to their ship's mast as they approach the mind-altering call of the Sirens.1 He forbids his crew to unlash him lest they all be destroyed and never reach their beloved Ithaca. Translated into a modern idiom, Odysseus outlines an advance directive for when he is decisionally incapacitated by the Sirens' seductions. He gives consent to his crew to bind and restrain him though he might ask for release. See also pages 401 and 412 Addressing the ethics of medication-free research in schizophrenia, we can consider informed consent and protection of human subjects in light of this classical tale. Does the consent of a competent schizophrenic subject extend into a period of psychosis resulting from the agreed-upon drug-free interval? If consent is a process to be maintained over time,2 then how is ongoing voluntariness3 assured when the References 1. Homer. The Odyssey. 2. Lidz CW, Appelbaum PS, Meisel A. Two models of implementing informed consent . Arch Intern Med . 1988;148:1385-1389.Crossref 3. Nuremberg Code. Reprinted in Levine RJ. Ethics and Regulation of Clinical Research . 2nd ed. New Haven, Conn: Yale University Press; 1988. 4. Carpenter WT Jr, Schooler NR, Kane JM. The rationale and ethics of medication-free research in schizophrenia . Arch Gen Psychiatry . 1997;54:401-407.Crossref 5. Office for Protection From Research Risks. Protecting Human Research Subjects: Institutional Review Board Guidebook. Washington, DC: US Government Printing Office; 1993:6-29-30. 6. Appelbaum PS. Drug-free research in schizophrenia: an overview of the controversy . IRB . 1996;18( (1) ):1-5.Crossref 7. Roth LH, Meisel A, Lidz CW. Tests of competency to consent to treatment . Am J Psychiatry . 1997;134:279-284. 8. Drane JF. Competency to give an informed consent: a model for making clinical assessments . JAMA . 1984;252:925-927.Crossref 9. Buchanan AE, Brock DW. Competence and incompetence . In: Deciding for Others: The Ethics of Surrogate Decision Making . New York, NY: Cambridge University Press; 1990:51-57. 10. Dresser R. Mentally disabled research subjects: the enduring policy issues . JAMA . 1996;276:67-72.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

The Call of the Sirens: Navigating the Ethics of Medication-Free Research in Schizophrenia

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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1997.01830170031005
Publisher site
See Article on Publisher Site

Abstract

Abstract IN THE Odyssey, Odysseus directs his men to tie him to their ship's mast as they approach the mind-altering call of the Sirens.1 He forbids his crew to unlash him lest they all be destroyed and never reach their beloved Ithaca. Translated into a modern idiom, Odysseus outlines an advance directive for when he is decisionally incapacitated by the Sirens' seductions. He gives consent to his crew to bind and restrain him though he might ask for release. See also pages 401 and 412 Addressing the ethics of medication-free research in schizophrenia, we can consider informed consent and protection of human subjects in light of this classical tale. Does the consent of a competent schizophrenic subject extend into a period of psychosis resulting from the agreed-upon drug-free interval? If consent is a process to be maintained over time,2 then how is ongoing voluntariness3 assured when the References 1. Homer. The Odyssey. 2. Lidz CW, Appelbaum PS, Meisel A. Two models of implementing informed consent . Arch Intern Med . 1988;148:1385-1389.Crossref 3. Nuremberg Code. Reprinted in Levine RJ. Ethics and Regulation of Clinical Research . 2nd ed. New Haven, Conn: Yale University Press; 1988. 4. Carpenter WT Jr, Schooler NR, Kane JM. The rationale and ethics of medication-free research in schizophrenia . Arch Gen Psychiatry . 1997;54:401-407.Crossref 5. Office for Protection From Research Risks. Protecting Human Research Subjects: Institutional Review Board Guidebook. Washington, DC: US Government Printing Office; 1993:6-29-30. 6. Appelbaum PS. Drug-free research in schizophrenia: an overview of the controversy . IRB . 1996;18( (1) ):1-5.Crossref 7. Roth LH, Meisel A, Lidz CW. Tests of competency to consent to treatment . Am J Psychiatry . 1997;134:279-284. 8. Drane JF. Competency to give an informed consent: a model for making clinical assessments . JAMA . 1984;252:925-927.Crossref 9. Buchanan AE, Brock DW. Competence and incompetence . In: Deciding for Others: The Ethics of Surrogate Decision Making . New York, NY: Cambridge University Press; 1990:51-57. 10. Dresser R. Mentally disabled research subjects: the enduring policy issues . JAMA . 1996;276:67-72.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: May 1, 1997

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