Psychiatric research ethics: An overview of evolving guidelines and current ethical dilemmas in the study of mental illness

The field of psychiatry has an opportunity to construct a more refined, per haps more enduring understanding of the ethical basis of mental illness res earch, The aim of this paper is to help advance this understanding by 1) tr acing the evolution of the emerging ethic for biomedical experimentation, i ncluding recent recommendations of the President's National Bioethics Advis ory Commission, and 2) reviewing data and concepts related to compelling et hical questions now faced in the study of mental disorders. Empirical findi ngs on informed consent, the ethical safeguards of institutional review and surrogate decision making, and the relationship between scientific and eth ical imperatives are outlined. Psychiatric researchers will increasingly be called ripen to justify their scientific approaches and to seek ways of sa feguarding the wellbeing of people with mental illness who participate in e xperiments. Most importantly, psychiatric investigators will need to demons trate their appreciation and respect for ethical dimensions of investigatio n with special populations. Further empirical study and greater sophisticat ion with respect to the distinct ethical issues in psychiatric research are needed. Although such measures present many challenges, they should not in terfere with progress in neuropsychiatric science so long as researchers in our field seek to guide the process of reflection and implementation. (C) 1999 Society of Biological Psychiatry.