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Potential Inability to Provide Informed Consent Due to Substance Abuse

Title: Potential Inability to Provide Informed Consent Due to Substance Abuse

Author: Celia B. Fisher, Decoding the Ethics Code: A Practical Guide for Psychologists, Sage Publications, 2003


Researchers develop creative ways to evaluate the consent of participants whose capacity to give truly informed consent may be compromised due to substance use and/or other comorbid disorders. Fisher presents this as an example of best practice.

Headings: Special Populations and Cultural Competence; Mental health disorders, participants with (including addictive disorders and developmental disabilities); Informed Consent: Disclosure and Deception; Obstacles to informed consent

Case Type: Illustrative

Potential Inability to Provide Informed Consent Due to Substance Abuse

A research team was conducting a study on HIV-related risk behaviors in community-dwelling adults with substance abuse disorders. Although there were gross measures of detecting consent incapacity (i.e., behavioral indicators of high levels of intoxication), the researchers realized there was little empirical evidence that could help evaluate whether the participants who might be suffering from comorbid disorders actually understood the informed consent information. Such comorbidity would only be formally evaluated once the individual consented to study participation. With approval from the IRB, the investigators decided to tape-record the informed consent procedures so that they could analyze in detail the participant’s understanding of the information and develop ways of improving the process. At the beginning of the informed consent process, investigators told each prospective participant they were going to describe the study so the individual could decide if he or she wanted to participate. They also told prospective participants they would be asked questions to make sure they understood the consent information. They then asked for permission to tape-record responses to the questions. They pointed out that the participant’s name would not be mentioned on the tape and that they could request that the tape be destroyed. Only the responses of individuals who gave permission were recorded.