Applying ethical guidelines in nursing research on people with mental illness

This article describes how ethical guidelines have been applied while inter viewing psychiatric patients who were recovering from mental illness, espec ially from psychosis, to allow nurses to understand these patients' experie nces. Because psychiatric patients are vulnerable, their participation in r esearch involves ethical dilemmas, such as voluntary consent, legal capacit y to consent, freedom of choice, and sufficient knowledge and comprehension . The first part of this article describes the most important ethical guide lines concerning human research. These have been published by different org anizations, departments, committees and commissions for the purpose of prot ecting human rights and dignity whenever research participants are vulnerab le persons or their capacity to consent is limited. At present, however, no special regulations govern research involving adults who have been diagnos ed with a condition characterized by mental impairment. Furthermore, a rela tively small body of research has documented the effects of various disorde rs (e.g. psychiatric conditions) on decision-making capacity per se. One ba sic moral and policy question is whether these individuals should ever be i nvolved in research. The second part of this article concentrates on how th e investigator made sure that participating patients had understood their r ole in this particular piece of nursing research. During the interviews the investigator noticed that some ethical dilemmas required further study and debate because of the lack of consensus on the proposed regulatory provisi ons on research involving institutionalized persons and their ability to ma ke an informed and voluntary decision.