Overview

Principles

Acceptability

Consent

Debriefing

PI Responsibilities

IRB/HRPP Considerations

Regulations

Overview

Special responsibilities are required of researchers who intend to provide participants with misleading information about research or deliberately withhold information from them. This guidance lays out these responsibilities and expectations, and the considerations required of the IRB when reviewing research requesting to use deception or incomplete disclosures.

Brown University applies these responsibilities, expectations, and considerations to research using both deception and incomplete disclosures.

Deception: Intentionally providing misleading or false information to participants.

Examples include when researchers tell participants:

  • They perform poorly on a task, regardless of their actual performance.
  • About a research activity that is not a task they will actually be expected to complete.
  • To expect pain from an activity, but no painful procedure will be administered.
  • That a task will be more difficult or take longer than it truly will.

Incomplete disclosure: Withholding information about the true purpose or nature of the study.

Examples include when researchers do not tell participants:

  • The specific purpose of the study, and only provide general information about the purpose.
  • That performance on tasks will be assessed, and only include information about how much time was spent on tasks.
  • That a timed puzzle they are asked to complete cannot be completed in order to assess frustration.
  • That observation of group dynamics is the true purpose of the study, and only inform participants that they will be asked to complete organized, group activities.

Guiding Principles

In The Belmont Report, the basic ethical principle of “respect for persons” has two rules: (1) individuals should be treated as autonomous agents, and (2) persons with diminished autonomy are entitled to protection.

The application of this principle during the consent process includes the essential elements of disclosure of information, comprehension by the prospective participant, and voluntariness of participation. The assertion is that withholding information from participants about a research study, when there are no compelling reasons to do, shows a lack of respect and denies participants the ability to make decisions for themselves.

However, the principle recognizes a problem may arise during the consent process when informing participants of a specific portion of the research is likely to impair the validity of the study.

When Is Deception or Incomplete Disclosure Acceptable?

The use of deception or incomplete disclosure may be appropriate to promote scientific validity by helping researchers acquire unbiased answers from participants about attitudes and behavior in circumstances where collecting candid information may result in biased responses.

For all research studies, such requests are justified only if it is clear that:

  1. The study is minimal risk;
  2. There are no undisclosed risks to participants;
  3. The request is truly necessary to accomplish the goals of the research;
  4. There is an adequate plan for debriefing participants, when appropriate; and
  5. There is an adequate plan for dissemination of research results to participants.

Researchers must always answer participants truthfully when asked a direct question about the research.

When Is Deception or Incomplete Disclosure Not Acceptable?

It is important to distinguish between studies in which deception or incomplete disclosure would invalidate the research from studies in which deception or incomplete disclosure would simply inconvenience researchers.

For all research studies, such requests cannot be approved if:

  1. The study is greater than minimal risk;
  2. Any information about study-related risks are withheld;
  3. Alternatives are available to accomplish the goals of the research that do not involve deception or incomplete disclosure;
  4. The request is intended to unduly influence people to volunteer for a study they would not otherwise enroll into; and
  5. The request places participants at financial, physical, legal, psychological, or social risk.

Consent Process

Prospective Agreement: For many studies it is sufficient for researchers to include prospective agreement to the deception or incomplete disclosure in the consent process. That is, researchers should inform prospective participants that they are being asked to enroll in research in which some portions will not be explained until the study has ended.

Exempt Research: Deception or incomplete disclosure is acceptable in Exempt research studies with the use of a prospective agreement.

  • Exempt Category #3: Benign Behavior Intervention – Requests for research under this category cannot be granted unless participants provide prospective agreement and are informed that they will be unaware of or misled regarding the nature or purpose(s) of the research, if applicable.

Alteration of Consent:

The IRB may approve a request for a consent process that alters or omits some the required elements of informed consent, as long as the study meets the following requirements:

  1. The research involves no more than minimal risk;
  2. The research could not practicably be carried out without the requested alteration;
  3. If the research involves using identifiable, private information or identifiable biospecimens, the research could not practicably be carried out without using such information or biospecimens in an identifiable format;
  4. The alteration will not adversely affect the rights and welfare of the participants; and
  5. Whenever appropriate, the participants will be provided with additional pertinent information after participation.

The IRB will not approve a request for an alteration of consent if:

  1. The consent process omits all or alters most of the elements of informed consent;
  2. Informed consent is sought under circumstances that do not provide the prospective participant sufficient opportunity to discuss and consider whether or not to enroll in the study, and that minimize the possibility of coercion and undue influence;
  3. The information that is given to prospective participants is not in a language that is understandable to the participant; and
  4. The prospective participant is not provided with the information that a reasonable person would want to have in order to make an informed decision about whether to volunteer, and an opportunity to discuss that information.
  5. The study is FDA-regulated research.

Debriefing

In The Belmont Report states that all research studies using deception or incomplete disclosure should have an adequate plan for debriefing participants when it is appropriate.

Debriefing: Explaining to participants that investigators intentionally provided them with misleading information about the study or that information about the study was withheld from them.

The goal of debriefing participants is to reduce the harm of the deception or incomplete disclosure. Investigators should design a respectful and thoughtful debriefing process with this goal in mind.

The investigator, in collaboration with the IRB/HRPP, will determine if a debriefing process is appropriate for the participants.

What Should A Debriefing Process Include?

The debriefing process should be simple, clear, and informative.

This goal is met by investigators:

  1. Explaining the nature of the deception or incomplete disclosure;
  2. Removing any effects of false information participants may have been given;
  3. Disclosing all elements of the study that may have been withheld;
  4. Educating participants about the research process, why the deception or incomplete disclosure was necessary, and how false beliefs can sometimes continue after participation;
  5. Asking permission to use the participant’s information if it is identifiable;
  6. Allowing participants to ask questions; and
  7. Thanking participants for their time and making them feel they are an important part of the research process.

The debriefing process should occur within a reasonable amount of time after the participant has completed study procedures. If a participant withdraws from the study prior to the study’s completion and the consent document does not specify that their data will be destroyed if they withdraw, they should receive the same debriefing process as the completed participants.

If debriefing participants after they complete study procedures could compromise study results, investigators may request that the process be delayed until study completion. Based on the type of study, deception, or incomplete disclosure, the debriefing process may be conducted by phone or online for a conversation between the participant and a researcher; or by mail, e-mail, or participants can be sent to a website where they can read the debriefing information at a date upon which the information will be available.

When Is A Debriefing Process Not Appropriate?

It may not be appropriate to debrief participants if informing them about the deception or incomplete disclosure may cause more harm than the deception or incomplete disclosure itself.

If a participant withdraws from the study prior to the study’s completion and the consent document specifies that their data will be destroyed if they withdraw, they do not need to have a debriefing process like completed participants, as their data will be destroyed.

Investigator Responsibilities

When requesting to conduct research that involves deception or incomplete disclosure, investigators must ensure that the research meets their discipline’s professional code of ethics and convey in their protocol to the IRB/HRPP how the particular consideration has been given to the consent and debriefing processes, and risk/benefit ratio of the research.

The IRB/HRPP protocol must:

  1. Justify the reasons for deceiving or withholding information from participants;
  2. Explain why the deception or incomplete disclosure is necessary;
  3. Describe how the potential benefits of the research justify the deception or incomplete disclosure;
  4. Outline the debriefing process, including (a) when, (b) how, and (c) by whom the information will be provided to participants; and
  5. Include a copy of the debriefing script.

IRB/HRPP Considerations

When reviewing research that involves deception or incomplete disclosure, the IRB/HRPP must evaluate the information provided by the investigator (under “Investigator Responsibilities”) and consider the following:

  1. The prospect of alternative procedures to the deception or incomplete disclosure;
  2. The likelihood that the deception or incomplete disclosure will unduly influence or coerce people to enroll in the study;
  3. The possibility of causing harm from the deception or incomplete disclosure, and the ability to remove that harm through the debriefing process;
  4. The potential of the deception or incomplete disclosure to facilitate unwanted and inappropriate invasions of participant privacy; and
  5. Whether the investigator has the expertise and resources to minimize potential participant concerns and/or distress caused when the participant is debriefed.

The IRB/HRPP will not approve:

  1. Deception for greater than minimal risk research;
  2. Incomplete disclosure for research that requests to withhold information that would be important to a person’s decision to enroll in the study; or
  3. Alteration of consent for the purposes of deception or incomplete disclosure for FDA-regulated research (Expedited Category #1 or Category #9, when applicable).

The IRB/HRPP must determine that the research qualifies for an alteration of consent, in accordance with the criteria provided in the federal regulations in 45 CFR 46.116(f).

Regulations & References

Brown University

U.S. Department of Health and Human Services (DHHS) Federal Regulations

DHHS - Office for Human Research Protections (OHRP)