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Screening for Suicidality in the Emergency Department: When Must Researchers Act to Protect Subjects' Interests?

机译:在急诊室筛查自杀行为:研究人员何时必须采取行动保护受试者的利益?

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The emergency department (ED) is a key site in preventing suicide. Yet there has been very little research on ED screening and interventions targeting the suicidal patient. Conducting research on interventions for preventing suicidal behavior in the ED population may evoke the dilemma of how to fulfill ethical obligations to protect research subjects when doing so can impair the validity of the study. In this paper we present a case study of a research protocol on the utility of routine screening with a brief intervention for suicidal ideation that raised issues regarding researchers' obligation to disclose information about subjects' suicidality to ED staff. After exploring the imperfect relationship between suicidal ideation and completed suicide (i.e., many people with ideation never attempt or commit suicide), we present an analysis of the causal relationship between these phenomena. This leads us to suggest that it should not be mandatory for researchers to disclose to ED staff when a subject reveals suicide ideation in a screening questionnaire—although other preventive measures may be called for. In general, the extent of the duty placed on researchers to intervene on behalf of their subjects should be proportional to the likelihood and magnitude of risk presented to subjects by the underlying condition, and should be balanced against the importance of the research question.View full textDownload full textKeywordsemergency department, research ethics, screening, suicide preventionRelated var addthis_config = { ui_cobrand: "Taylor & Francis Online", services_compact: "citeulike,netvibes,twitter,technorati,delicious,linkedin,facebook,stumbleupon,digg,google,more", pubid: "ra-4dff56cd6bb1830b" }; Add to shortlist Link Permalink http://dx.doi.org/10.1080/13811118.2011.565271
机译:急诊科(ED)是预防自杀的重要场所。然而,关于ED筛查和针对自杀患者的干预措施的研究很少。开展有关预防ED人群自杀行为的干预措施的研究可能会引起如何履行道德义务以保护研究对象的困境,而这样做可能会损害研究的有效性。在本文中,我们以常规筛查的实用性为研究方案的案例研究,并通过简短的自杀意念干预提出了有关研究人员向ED人员披露有关受试者自杀信息的义务的问题。在探讨了自杀意念与完全自杀之间的不完美关系之后(即许多有意念的人从未尝试或自杀),我们对这些现象之间的因果关系进行了分析。这导致我们建议,当受试者在筛查问卷中显示自杀意念时,研究人员不应该向ED人员披露信息,尽管可能需要采取其他预防措施。一般而言,研究人员代表研究对象干预的责任的程度应与基础情况对研究对象提出的风险的可能性和大小成正比,并应与研究问题的重要性相平衡。全文下载全文关键字紧急部门,研究伦理,筛查和自杀预防,pubid:“ ra-4dff56cd6bb1830b”};添加到候选列表链接永久链接http://dx.doi.org/10.1080/13811118.2011.565271

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