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Why does informed consent fail? A discourse analytic approach
David E Ness1, Scott F Kiesling, Charles W Lidz
1Baylor College of Medicine, Houston, TX, USA. dness@menninger.edu
The Journal of the American Academy of Psychiatry and the Law
|September 22, 2009
Summary
Informed consent interviews often fail due to communication breakdowns. Linguistic discourse analysis reveals how conversational elements and framing impact participant understanding and autonomous decision-making in research.
Area of Science:
- Medical Ethics
- Linguistics
- Clinical Research
Background:
- Informed consent is crucial for ethical research participation.
- Current methods often fail to ensure prospective subjects fully understand research.
- Therapeutic misconception remains a significant challenge in informed consent.
Purpose of the Study:
- To analyze failures in informed consent using linguistic discourse analysis.
- To understand how conversational elements and discourse framing affect participant understanding.
- To explore the extent to which subjects explore concerns relevant to research choices.
Main Methods:
- Applied linguistic methods of discourse analysis to informed consent interview transcripts.
- Analyzed elements of conversation and discourse framing.
- Assessed subject's level of understanding, therapeutic misconception, and exploration of concerns.
Main Results:
- Lapses and miscommunications in informed consent can be specifically identified through conversational elements and framing.
- Discourse analysis provides a detailed, language-based understanding of consent process failures.
- Identified specific linguistic patterns contributing to inadequate informed consent.
Conclusions:
- Linguistic discourse analysis offers a valuable alternative to abstract or inferential approaches to studying informed consent.
- Findings have implications for improving informed consent processes through targeted educational and research strategies.
- Understanding the micro-level linguistic interactions is key to enhancing ethical research participation.
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