Ethical Issues Involved With \"On Being Sane

Ethical Issues involved with "On Being Sane in Insane Places"

L Rosenhan's On Being Sane in Insane Places was both a historic and ground-breaking research study which provided invaluable information on the views of mental health professionals toward their patients. (Rosenhan, 1973) In this revealing study, several researchers, who had never displayed any abnormal behavior in their pasts, admitted themselves into a variety of mental health facilities and studied the behavior of the staffs of these institutions toward their patients. What these pseudo-patient researchers discovered rocked the scientific community by exposing those who treat mentally ill patients often have preconceived notions toward their patients and their behavior. The stigma of being labeled as "mentally ill" often clouded the staff's evaluation of the behavior of the pseudo-patients. And once labeled as "mentally ill" it was almost impossible to reverse that finding. (Rosenhan, 1973) This was an important, study which revealed vital information about mental heath professional's attitudes and behavior toward their patients, but also violated several ethical issues.

In order to gain admittance to the facilities, the researchers were forced to deceive the staff of these institutions by lying about their symptoms. (McBurney, 2007) While they behaved in every way "normal" once they were admitted, the mere fact that they deceived the staff raised serious ethical questions. The staff of these institutions were forced to base their evaluations of the pseudo-patient's behavior from the point-of-view that the pseudo-patients were indeed mentally ill, a false premise. Their subsequent failure to recognize seemingly "normal" behavior as normal can be explained by the fact that they were looking through the lens of mental illness. In other words, if the staff was told the patient was mentally ill, then they would treat the patient as though they were mentally ill; and not look for other reasons to explain their "normal" behavior other than their mental illness was "in remission." While deception can be ethical when necessary, it this case the staff did not have the full knowledge about their patients, and thus were unable to perform their duties correctly thereby influencing the study's results.

Beside the fact that they lied about their psychological condition, another ethical standard these researchers violated was not asking the staff's permission to use them in their research, the researchers did not get the informed consent of the staff. (McBurney, 2007) The staff was not made aware that they were being studied and thus could not give their permission. The fact that they did not know they were being studied also denied the staff their right to refuse to participate, and by extension their right to withdraw from the study. Modern ethical standards require that all subjects be fully informed of the study being conducted and must voluntarily give their permission to participate. The subjects must also have the right to withdraw from the study at any time for any reason without penalty. These standards were violated by Rosenhan's research project.

In order to deal with these ethical issues, the study could be modified so as to include modern ethical standards. Firstly, staff at mental health facilities must be asked when they are hired if their behavior may be observed by anyone in the facility, including patients, but make it out as a routine practice and let them know that they can refuse to participate at any time and will not be reprimanded for anything observed. Over time, the staff may forget about the monitoring, or put it out of their minds, and slacken in their attempt to "show-off" for the researchers, especially if it is never mentioned after the first encounter. In this way the researchers will have the permission of the staff to be observed, the staff will never know if they are being observed or not, or by whom. In time the staff should behave normally, or at least in a way that won't influence the study.