What if the director of a treatment organization is approached by researchers interested in testing an intervention for gambling disorders? That director is then confronted with a decision that involves weighing the risks of a clinical trial against the potential benefits for the clients who participate in the trial and the larger society. How can treatment providers ensure that such research would be conducted ethically? In this dispatch from the Midwest Conference on Problem Gambling & Substance Abuse, I report on Dr. Catherine Striley’s workshop on “Research & Practice Ethics: What You Need to Know.”
According to Dr. Striley, research assistant professor of psychiatry at Washington University in St. Louis, ethical research ensures rigorous research, and rigor ensures benefits from the research. Research investigations always involve a level of risk, and there must be a corollary benefit – in the form of a more effective treatment or a better understanding of the disorder–if the investigation places people at risk. Therefore it is vital for treatment organizations to be fully aware of the ethical issues involved so that informed decisions can be made about participating in research investigations. The following are examples of the types of questions that should be asked of the researchers:
- Has your Institutional Review Board (IRB) approved the research investigation? IRBs are committees at universities and research centers that review all proposed research by the institution’s faculty to ensure that human subjects and animals are protected.
- How do you plan to protect the confidentiality of the research participants?
- What are the risks of the research, and how do you plan to mitigate these risks? The most obvious example of a risk would be participant’s adverse reaction to medication in a drug trial.
- What is your hypothesis based on? In other words, does the scientific literature support the testing of the proposed intervention?
Dr. Striley offered case studies to spark audience discussion. One conversation focused on the incentives offered to individuals involved in gambling research. Recruiting and retaining participants in research projects on gambling has been challenging. I raised the question of whether increasing incentives or switching to cash payments would make a difference and, if so, what are the ethical implications. It appears that most IRBs prefer gift certificates as opposed to cash payments in research focused on gambling, alcohol and drugs out of a desire to prevent the participants from using the cash to gamble or buy alcohol and drugs. The group discussed whether this approach is an example of protection or paternalism. The clinicians in the session also observed that gift certificates can be easily sold on the street for cash, rendering this approach ineffective for some research participants.
What do you think about the issue of providing incentives for gambling research participants? We welcome your thoughts and questions in the comments section below.
