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August 29, 2014

Medical research involves a lot of deception. Should it?

Daily Briefing

    Researchers have long used deception to conduct clinical trials, but the practice can lead to "mistrust of scientists or the medical system in general," Shirley Wang writes in the Wall Street Journal.

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    Some experts say deception may be a necessary evil to arrive at honest findings. Often, deception is used when informing participants of the nature of the study would affect their behaviors. It is also used in double-blind studies of drug treatments to prevent bias from affecting the results.

    But it's not always clear if deceiving study participants is ethical.

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    For example, Australian researchers surveyed tens of thousands college students about their drinking habits without disclosing that the survey was part of an alcohol intervention. Researchers say that disclosing the goal at the beginning would have changed the students' behaviors and disclosing the goal at the end would have made the students felt misled, so they never did so. The "intervention" was a subtle one: Students changed their drinking habits after they were enlightened by their survey responses.

    The research explained why they through the deception was ethical when they publishing their study in the American Journal of Bioethics in 2013. But other scientists disagreed with their methods and commented on its ethics.

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    Likelihood of public benefit is a "necessary condition" for deception, says Kypros Kypri, an author of the Australian study. He adds, "I'm confident in the studies we've reported, that the research question is important for public health, that the risk to participants was very low, and that there was no other way to answer the question."

    The concept of "the ends may justify the means" may be used to judge whether knowledge gained through deception is an ethical practice, says Rebecca Dresser, a professor of ethics in medicine at Washington University in St. Louis. Still, there are ways to limit deception and its effects, such as telling participants about the deception at the end of the study, Dresser says.

    Moreover, deception often can be avoided altogether, Dresser argues. For instance, researchers in a 2000 study gave patients asthma inhalers with trackers that registered when the inhalers were used. The participants were not told that inhalers contained trackers. The researchers found that patients lied about using the inhalers regularly and some even dumped them.

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    So, why lie about the trackers? Dresser says.

    "I think that's respectful of people so they accept those conditions. You can tell them what's going on, and you don't have to deceive them," Dresser says (Wang, Wall Street Journal, 8/26).

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