Informed Consent
Leah Gottlieb, Andrew Glaid, Thomas Goehring, Sebastien Hebert, David George
Mentor: Dr. Michael Cascio
Milgram Case (1960s, Yale University)
Stanley Milgram’s experiment was a test to see why good people do bad things. It was done in response to the Nazi War Crime Trials in Jerusalem, where the Nazis’ common excuse was they were “only following orders”. The experiment tested and recorded the reaction of a person when they are required to shock someone else. The subject was to give a series of questions to an actor and when the actor answered a question wrong, the actor was “punished” with a shock. If the subject hesitated to shock the actor, then the experimenter would pressure him. This experiment took place at a time when the rules of human emotion were very lenient.
Other psychologists took issue with the study because participants were not reminded that they could opt out of the study and were deceived about their role in the experiment. As a result, participants exhibited signs of distress during testing and were emotionally scarred. Some even had laughing fits and seizures at the end of the study. However, Milgram claimed that many enjoyed it and some offered to be in future experiments. Milgram was not harshly punished, but his acceptance within the American Psychological Association was stalled for one year. As a result of this experiment, more restrictive ethics guidelines were put into place.
By providing informed consent, participants in any study or medical procedure can feel at ease about their participation, while doctors and those conducting the experiments can avoid malpractice lawsuits. However, if participants had been informed about the details of the experiment, the results of the study would have been compromised. This brings up the dispute about conducting experiments “for the greater good”, where an individual’s well being could be compromised for the good of society. This study, while causing emotional harm, did shed light on an unfortunate truth about humanity.
HIV Case (1998, South Africa)
In order to provide informed consent to participants, sufficient information about the experiment or procedure and its consequences must be provided. Information often is provided in the form of lengthy legal documents that inhibit a clear understanding. This, however, does not avoid the fact that participants come from a variety of educational, cultural, sociological, etc. backgrounds, which may have an impact on their ability to understand the information that is provided to them.
In this study, female participants were provided with counseling both prior to and after HIV diagnostic testing. A survey was also conducted to gauge the participants’ understanding and perceptions of the diagnosis. Although participants were often informed about their ability to abort participation, they felt compelled to remain in the study. The pre-counseling surveys also showed that they had a skewed perception of what would occur due to a positive diagnosis. For example, 93% of participants believed that they would lose their jobs, while only 39% believed the same thing post-counseling. This study, therefore, shows that participants must not be coerced and be provided with clear information prior to participation.
Due to the negative connotations association with HIV/AIDS, people are less likely to participate in a study. They often have concerns that the information may leak out and be accessible to third parties, such as insurance companies, who could, in turn, limit or eliminate the availability of health care.
References:
Banyard, P., “The Case Against Milgram”, The Open University, 2012
Billikopf, G., “Milgram’s Experiment on Obedience to Authority”, Encina University of California, 2003
Herrera, C. D. (2001), Ethics, Deception, and ‘ThoseMilgramExperiments’. Journal of Applied Philosophy, 18:245–256.
KarimQ. A.,KarimS. S. A.,CoovadiaH. M.,SusserM. Informed consent for HIV testing inaSouth African hospital: Is it truly informedand truly voluntary? Am J Pub Health 1998;88: 637–40.
Veatch, Robert M.“TheBasics ofBioethics.” UpperSaddle River,NJ: Pearson Education, 2012. Print.