Informed consent and the limits of confidentiality

Investigators encounter many legal and ethical issues when they conduct res earch an partner abuse. Balancing abused women's rights to privacy with leg ally mandated reporting requirements involves considerable thought and plan ning. Failure to protect participants may result in escalation of abuse as well as loss of children to protective services. Various perspectives on ma intaining participant privacy while conforming to legal mandates to report child abuse, homicidality, and suicidality are discussed. The role of confi dentiality certificates in providing legal immunity for researchers and the method of obtaining the certificates are presented. In addition, the autho rs describe the strategies for participant protection that are implemented in a federally funded study of abuse, women's self-care, and pregnancy outc omes. The decision to clearly and specifically inform abused women of the l imits of confidentiality allows participants to make informed decisions abo ut disclosures, but may result in diminished recruitment.