Schizophrenia Bulletin Advance Access originally published online on September 28, 2005
Schizophrenia Bulletin 2006 32(1):129-136; doi:10.1093/schbul/sbj003
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Is Psychiatric Research Stigmatized? An Experimental Survey of the Public
2 Center for Behavioral and Decision Sciences in Medicine, University of Michigan
3 Department of Psychiatry and the Bioethics Program, University of Michigan
4 Veterans Affairs Ann Arbor Healthcare System
1To whom correspondence should be addressed; Bioethics Program, 300 North Ingalls Street, 7C27, Ann Arbor, MI 48109, tel: 734-936-5222, fax: 734-936-8944, e-mail: scottkim{at}umich.edu.
Although decisional incapacity can be caused by various medical conditions, incapacity due to mental illness is often singled out for scrutiny in research ethics policy debates. We assessed whether there is a general discriminatory perception of mental illness research and, if so, aimed to characterize the nature of that perception. We conducted an experimental, randomized Internet survey of the general public. We recruited 3140 adults through a web-research survey panel, with oversampling of racial and ethnic minorities and the elderly. Willingness to allow medical versus mental illness research was compared by randomly assigning the respondents to 1 of 7 web-based experimental scenarios depicting a subject being considered for research participation. Respondents were more willing to allow research with medically ill than the mentally ill subjects, even when ethically relevant factors were equal. This difference was mediated through the respondents' tendency to view mentally ill subjects as more decisionally incapable than medically ill subjects, even when they were told that the subjects portrayed were in fact competent. Discriminatory perception of mental illness research exists and is mediated by an outdated view of mental illness and decisional capacity. Policymakers and institutional review board members may need to guard against its influence in their deliberations.
Keywords: ethics / stigma / mental illness / schizophrenia / research attitudes / decision-making capacity
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