Changing patient preferences toward better trial recruitment: an ethical analysis

Pepijn Al*, Spencer Hey, Charles Weijer, Katie Gillies, Nicola McCleary, Mei-Lin Yee, Juliette Inglis, Justin Presseau, Jamie Brehaut

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

While randomized controlled trials are essential to health research, many of these trials fail to recruit enough participants. Approaching recruitment through the lens of behavioral science can help trialists to understand influences on the decision to participate and use them to increase recruitment. Although this approach is promising, the use of behavioral influences during recruitment is in tension with the ethical principle of respect for persons, as at least some of these influences could be used to manipulate potential participants. In this paper, we examine this tension by discussing two types of behavioral influences: one example involves physician recommendations, and the other involves framing of information to exploit cognitive biases. We argue that despite the apparent tension with ethical principles, influencing trial participants through behavior change strategies can be ethically acceptable. However, we argue that trialists have a positive obligation to analyze their recruitment strategies for behavioral influences and disclose these upfront to the research ethics committee. But we also acknowledge that since neither trialists nor ethics committees are presently well equipped to perform these analyses, additional resources and guidance are needed. We close by outlining a path toward the development of such guidance.
Original languageEnglish
Article number233
JournalTrials
Volume24
DOIs
Publication statusPublished - 28 Mar 2023

Fingerprint

Dive into the research topics of 'Changing patient preferences toward better trial recruitment: an ethical analysis'. Together they form a unique fingerprint.

Cite this