The Competence and Willingness to Consent to Research Among Patients with Heroin Dependence
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ORIGINAL ARTICLE
The Competence and Willingness to Consent to Research Among Patients with Heroin Dependence Liyan Zhao, MD1 · Hong Shi, MD2 · Bing Ying, MD2 · Qiang Li, MD2 Received: 12 June 2019 / Accepted: 24 January 2020 © The Drug Information Association, Inc 2020
Abstract Background Substance abuse research can raise ethical concerns about the comprehension and decision-making capacities of participants with drug dependence. In this study, the competence and willingness to consent to research participation were examined among patients with heroin dependence. Methods Twenty patients with heroin dependence and 24 healthy controls were asked to indicate if they would consent to participate in a low- and high-risk study. The MacArthur Competence Assessment Tool-Clinical Research was used to assess their consent capacities. Results Patients with heroin dependence and healthy controls did not differ significantly in their consent capacity scores. However, the patterns that underlay their decisions to consent and decline to participate in the two fictional studies were significantly different. Specifically, patients with heroin dependence were more likely to consent to participate in both studies, irrespective of the ratio of benefits to risks. Further, patients with heroin dependence who agreed to participate in the research studies did not demonstrate poorer decision-making capacities than their nonconsenting counterparts. Conclusions Although the decision-making capacities of patients with heroin dependence and healthy controls were similar, the patterns that underlay their decisions to consent or decline to participate in the studies differed significantly between the two groups. Future studies should identify the specific factors that account for these emergent group differences. Keywords Heroin dependence · Decision-making · Consent · Competence · Willingness
Introduction Heroin, which is one of the most commonly abused illegal drugs worldwide, can significantly impair the decision-making capacities of individuals with dependence. Consequently, such individuals consistently make more maladaptive choices than healthy controls [1, 2]. Excessive risk-taking tendencies are prevalent among individuals with dependence, and individuals with substance dependence disorders persistently seek drug reinforcement, despite the high * Liyan Zhao [email protected] * Qiang Li [email protected] 1
Peking University Health Science Center, 38, Xue Yuan Road, Beijing 100191, China
Department of Radiology, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi’an, Shaanxi 710038, China
2
risk of adverse consequences [3–5]. Individuals with heroin dependence tend to exhibit impulsive, hasty, and premature behaviors without adequate forethought, despite the possibility of undesirable consequences. In addition, patients with heroin dependence may be vulnerable because of their high rates of psychiatric comorbidities [6, 7]. Substance dependence research can raise ethical concerns about th
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