IRB Member Judgments of Decisional Capacity, Coercion, and Risk in Medical and Psychiatric Studies

WHILE INDIVIDUALS WITH PSYCHIATRIC illnesses are widely considered a special class of research subjects regarding decisional capacity and coercion vulnerability, those with physical illnesses often are not. IRB members (N = 127) read vignettes that described clinical research targeting one of two levels of disease severity (high/low) for psychiatric or medical diagnoses. They then rated decisional capacity, coercion, and risks for hypothetical research subjects. IRB members viewed psychiatric subjects as having greater vulnerability to coercion and less decisional capacity than medical subjects, even when medical illness was of a severity likely to engender psychiatric comorbidities. These results suggest that IRB members may inflate the vulnerability and decisional incapacity of psychiatric subjects, while discounting vulnerability and incapacity in medical subjects.