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Why Is Therapeutic Misconception So Prevalent?

Published online by Cambridge University Press:  26 February 2015

CHARLES W. LIDZ ,
KAREN ALBERT ,
PAUL APPELBAUM ,
LAURA B. DUNN ,
EVE OVERTON  and
EKATERINA PIVOVAROVA
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Abstract:

Therapeutic misconception (TM)—when clinical research participants fail to adequately grasp the difference between participating in a clinical trial and receiving ordinary clinical care—has long been recognized as a significant problem in consent to clinical trials. We suggest that TM does not primarily reflect inadequate disclosure or participants’ incompetence. Instead, TM arises from divergent primary cognitive frames. The researchers’ frame places the clinical trial in the context of scientific designs for assessing intervention efficacy. In contrast, most participants have a cognitive frame that is personal and focused primarily on their medical problems. To illustrate this, we draw on interview material from both clinical researchers and participants in clinical trials. We suggest that reducing TM requires encouraging subjects to adjust their frame, not just add information to their existing frame. What is necessary is a scientific reframing of participation in a clinical trial.

Keywords

therapeutic misconceptioninformed consentclinical trialsresearch ethics
Type
Departments and Columns
Information
Cambridge Quarterly of Healthcare Ethics , Volume 24 , Issue 2 , April 2015 , pp. 231 - 241
Copyright
Copyright © Cambridge University Press 2015 

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References

Notes

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