The biggest question raised over the past few years has been whether there are system-wide and pervasive breaches of what would be considered safe and ethical research. In spite of the claims of a small number of vocal extremists, the consensus is that there is not widespread and systematic abuse of patients who are subjects in psychiatric research. There is certainly no evidence to justify the exaggerated comparisons that have been made to Nazi medical experimentation and the Tuskegee syphilis study. While it must be acknowledged that there may have been isolated studies that were not carried out in strict accordance with ethical guidelines, there is no indication that this occurs in psychiatric research any more than in other types of medical research. Simultaneously, it is widely accepted that more can be done to systematically ensure the safety of all subjects in psychiatric research.
Informed consent is a fundamental element of ensuring that medical research is ethical and just.
People may submit themselves to possible risk or inconvenience or forego the certainty of specific treatments to participate in a study as an expression of their personal autonomy, individual rights, and humanitarian interest. However, this is only ethical if the research participants have been fully informed about the study and have entered into it voluntarily. There is often an inference or assumption that mental health consumers by virtue of their illness are not competent enough to understand the issues and to give informed consent. Indeed, many if not the majority of mental health consumers are able to provide informed consent. Moreover, to say that persons with mental illness are incompetent and deprive them as a group of the opportunity to participate in research would be unfair and ultimately would be to their disadvantage.