Deception in

Clinical
Research
C – 07 DULAWAN
Guide Questions

▪ Is the use of deception in a clinical setting morally

permissible?
▪ If there is an alternate, nondeceptive way of doing an
experiment which may be more costly and less effective,
should we pursue this instead to avoid committing
deception?
▪ Is the use of Authorized Deception better in research that
requires it? Are there any cases that it is more
troublesome?
The Nature of Deception

▪ Deception is the act of propagating a belief that is not true, or is

not the whole truth.
▪ It occurs when investigators communicate – understand broadly
to include written, spoken and behavioral communication – in
ways that can reasonably be expected to result in participants
developing false beliefs.
▪ Investigators may also deceive participants by withholding
important information from them.
The Milgram Experiments

HOW SHOCKING OH NO
The Milgram Experiments

▪ Stanley Milgram, 1963

▪ Carried out in Yale University
▪ “Could it be that Eichmann and his
million accomplices in the
Holocaust were just following
orders? Could we call them all
accomplices?" (Milgram, 1974).
▪ After the initial experiment, he
conducted more experiments
• The experiment was conducted to justify for acts of genocide
offered by those accused at the World War II, Nuremberg War
Criminal trials.

• Milgram researched on people’s obedience to authority.

• He was interested in how people could easily be influenced in
committing atrocities.
The Experiment

1. Forty participants ranging from 20 to 50 years old were recruited to

take part in Milgram’s experiment.
2. The participants came in with another person, where they draw lots to
determine who will become the “Teacher” and the “Learner”.
3. The draw was fixed so the participant would always be the “Teacher”,
while the person, who was actually one of Milgram’s confederates
would be the “Learner”.
4. The participants were instructed to deliver electric shocks to the
“Learner” for each wrong answer given. >
The
shocks
ranged
from 15
to 400
volts.
Results and Conclusion

▪ 65% of participants continued to the highest level of 450 volts.

▪ Milgram then concluded that people are likely to follow orders, as long
as they recognize their authority as morally right and/or legally based.
▪ He summed it up in his article “The Perils of Obedience”, where he
suggested that people have two states of behavior in a social
situation.
Autonomous State - people direct their own actions, and they take responsibility for the results
of those actions.
Agentic state - people allow others to direct their actions and then pass off the responsibility for
the consequences to the person giving the orders
Deception - the participants actually
believed they were shocking a real person
and were unaware the learner was a
confederate of Milgram’s.
Protection of participants – the
participants were exposed to stressful
situations that may have the potential to Ethical Issues
cause psychological harm. Many of the
participants were visibly distressed.
Right to Withdrawal – many participants
refused to deliver the electric shock. The
experimenter was told to give a series of
commands or prods to ensure obedience.
Why is Deception used in Clinical Research?

▪ Used in Placebo-controlled trials to determine expectancy effects

from drug effects.
▪ Psychology experiments sometimes use deceptive techniques to
obtain data.
▪ May become an issue in some experiments, such as the Milgram
Experiments.
Harms of Deceptive Clinical Research

▪ Participants may be distressed once they are deceived.

They may also lose trust in the investigators.
▪ It infringes their right to choose whether to participate in
the research based on full disclosure of relevant
information.
▪ Investigators fail to respect the autonomy of participants
by deceiving them.
Institutional Review Boards (IRBs)

▪ Also known as the Ethics Committee or Ethics board,

they review methods proposed for research to ensure
that they are ethical.
▪ They choose between having to respect personal
autonomy and gathering valid data, which occur in two
general kinds of studies.
▪ The research requires investigators to
deceive participants to obtain valid data.
▪ IRBs must determine whether the value of
answering these kinds of questions
justifies the harms of the deception
involved.
▪ This calculation is difficult to make, First Case
unless one has an estimate for the
potential harms of deception, which
usually cannot be answered by an
individual study.
▪ Some studies may have another method
where the use of nondeceptive means are
theoretically possible.
▪ These alternative studies may require
more resources and may produce less
powerful results.

Second Case
Regulation and Guidelines Governing Deception

▪ Most, if not all guidelines require participants’ informed consent.

▪ These, however, do not address deception explicitly, but allow
investigators to alter some or all elements of informed consent
provided that several conditions are satisfied.
▪ Most guidelines and regulations state, that, if the study requires
the withholding of information until debriefing, it must be
discussed with the ethical review boards who will decide on the
manner.
▪ Participants can be informed of the use of
deception.
▪ They are asked to consent to its use,
without being informed of the nature of
the deception.
▪ Authorized deception warns participants Authorized
of the risks that may occur during or after
the experiment while giving them a Deception
chance for them to have second thoughts
and back out.
 Objections to Authorized Deception

…Some concerns about

Informed Consent: Study Data: Harms:

▪ Valid consent requires ▪ Authorized Deception  People who consent to
full knowledge on the could confound a the study should be able
procedure study’s data if to gauge the extent to
participants tried to which being deceived will
▪ Knowledge of the discover the nature of
deception used may deception used. bother them.
impair validity of the  If awareness of the use of
research. deception concerns them
more than actually being
deceived, then the use of
A. D. would be less
effective.

oh yes goodnight its 4 in the morning y’all