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Ethical approaches to researching the mentally incapable patient

Academic Department of Psychiatry, Charing Cross Hospital, Fulham Palace Road, London W6 8RF

Sean Spence, Research Fellow

MRC Cyclotron Unit, Hammersmith Hospital, Du Cane Road, London W12 0HS

Patients seen in psychiatric settings may, for a variety of reasons, be incapable of informed consent. The Mental Health Act allows for their treatment, but research into their pathologies is practically impaired (while their consent is a criterion for inclusion). Is it ethically unacceptable to perform research upon these patients? If so, then the prospects for therapeutic and conceptual advance seem remote. In this paper the competing ethical claims are examined. An approach is proposed which is humane yet permissive of research in this heterogeneous group of patients.