Coercion and undue influence in decisions to participate in psychiatric research – conceptual issues

Abstract

The essential elements of informed consent to research include the provision of relevant information to a person who is competent to make a decision, and who is situated so as to be able to do so voluntarily. The nature of the requirement of voluntariness has been resistant to exploration. Concerns about voluntariness are usually invoked under the rubrics of coercion or undue influence. Coercion can be conceptualized as the use of morally unjustified threats to bring a person to consent to research participation. Undue influence in the research context typically involves the use of affirmative inducements to persuade a person to ignore what would otherwise be their preferences regarding research participation. Talcott Parsons noted four means by which influence may be exercised, involving respectively the use of appeals to shared goals, inducement, persuasion, and power. In the context of human subjects research, evocation of shared goals may be manifest by appeals to altruism; induce)