The ethics of human experimentation in psychiatry: toward a more informed consensus

In recent years, the expansion in medical research has been accompanied by a growing concern for human rights, and a proliferation of government regulations. These concurrent developments have generated a deepening uneasiness about the future of human experimentation in psychiatry. This troubled state of affairs points out the desirability of a moral consensus that will respect the concerns of those involved. Toward that end, we offer a method for assessing the arguments now crowding the literature and propose a set of paradigms of human experimentation--the scientific, authoritarian, market, fiduciary, collegial, and social--which appear to lie behind the clash of perspectives. It is our hope that these paradigms can contribute to a fair and sympathetic examination of the conflicting positions. While this in itself cannot guarantee a moral consensus, it can facilitate a clearer organization and understanding of priorities.