The latest issue of Research Ethics featured an article on the moral implications of manipulating information to obtain consent, which I thought was thought-provoking enough to warrant a blog entry.

To clarify, manipulation should not be construed as deliberate falsification: rather, it refers to issues such as presentation and framing that can influence the potential participants’ decisions. Let me illustrate, using a (slightly modified) example from the article: Apparently, the baseline risk of developing invasive breast cancer for women in a certain study was 68 cases per 10,000 per year, whereas treatment with a drug yielded an annual risk of 34/10,000. If I wanted to elicit your consent to take the drug, I could either inform you that it reduces the risk of cancer by 49%, or that by failing to take the drug you are increasing your chances of developing cancer by almost 100%. From a mathematical perspective, both statements convey the exact same information – but do they have the same effect? (p.12, citing Schwartz, Woloshin & Welch 1999: 129)

Using examples, the authors argue that manipulating information can, under circumstances, be morally justified, and may even empower participants to reach informed consent. According to them, when information manipulation methods “lead to morally unacceptable actions [this] is not due to their nature but due to the researcher’s immoral intentions” (p. 19). They go on to claim that:

Since the information about the proposed research participation is complicated and often not within the experience of the prospective subject in advance, the researcher should assess the understanding of the potential subjects continually and provide additional information as required to correct misperceptions or misunderstandings that may occur (manipulation of information, as we saw, in certain cases could be justified in order to achieve that). (p. 21)

Personally, I think that such an attitude might lead towards a slippery moral slope, especially in the absence of effective ethical oversight. That having been said, I do think that it’s an interesting change of perspective from the inflexible normative criteria that some review boards seem to prefer.

So, what is your take on all this? What might the impact of such practices be on research participants and on research? What safeguards do you feel should be in place to prevent abuse of such flexibility?