Ethical and Legal Duties in Conducting Research on Violence: Lessons from the MacArthur Risk Assessment Study

By Monahan, John; Appelbaum, Paul S. et al. | Violence and Victims, January 1, 1993 | Go to article overview

Ethical and Legal Duties in Conducting Research on Violence: Lessons from the MacArthur Risk Assessment Study


Monahan, John, Appelbaum, Paul S., Mulvey, Edward P., Robbins, Pamela Clark, Lidz, Charles W., Violence and Victims


This article addresses the ethical and legal duties that must be confronted in any study of the risk of interpersonal violence in the community. Ongoing research--the MacArthur Risk Assessment Study--on the markers of violence among released mental patients is taken as illustrative. Methods by which the researchers are discharging their legal and ethical duties are described and justified. Strategies center around the duty to protect research subjects from their own violence, and the duties to protect research staff and third parties from subjects' violence. By airing these rarely discussed issues, the authors hope to initiate a professional dialogue on crucial ethical and legal aspects of the research process.

The National Research Council's (NRC) Panel on the Understanding and Control of Violent Behavior (Reiss & Roth, 1993) recently recommended major increases in federal support for research on violent behavior. Prominent among the new research initiatives proposed by the NRC Panel to the Centers for Disease Control, the National Institute of Mental Health, the National Institute of Justice, and the National Science Foundation, was the intensified study of "risk factors for violent events" (Reiss & Roth, 1993, Recommendation 3 [b], p. 24).

For the past 5 years, we have been conducting the MacArthur Risk Assessment Study, an interdisciplinary, multisite study of risk factors for community violence in one specific population highly relevant to the NRC Panel's concerns: persons released from mental hospitals. Although only a small portion of the violence in American society can be attributed to mental disorder--3 %, according to the best epidemiological study (Swanson, Holzer, Ganju, & Jono, 1990)--mental disorder is consistently linked with violence in the perception of the general public (Monahan, 1992), and this perceived relationship with violence accounts for much of the social stigma attached to being a former mental patient (Link, Cullen, Frank, & Wozniak, 1987). Beliefs about an association between mental disorder and violence also play a key role in justifying involuntary civil commitment within the United States (Monahan & Shah, 1989) and worldwide (United Nations, 1991).

In this article, we address the ethical and legal duties that we have confronted in conducting the Mac Arthur Risk Assessment Study. These duties must be faced as part of any public health study of the risk of violence in open communities (Sieber & Sorensen, 1992). We also discuss the methods by which we are discharging these duties. Our strategies center on our duties to protect our research subjects from their own violence and to protect our research staff and third parties from our subjects' violence. By airing these rarely discussed issues, we hope that researchers may benefit from our experiences and that we might initiate a professional dialogue on these often perplexing ethical and legal aspects of the research process.

THE MacARTHUR RISK ASSESSMENT STUDY

MacArthur Research Network on Mental Health and the Law began to plan the MacArthur Risk Assessment Study in 1988. The purpose of the study is to identify valid risk markers for violence in a representative set of patients released from mental health facilities (Monahan & Steadman, 1994; Steadman et al., 1994). Approximately 1,000 patients (from one of three hospitals in three different cities) are being interviewed, first in the hospital and later in the community. The study sample includes men and women of white, African-American, or Hispanic race/ethnicity, who are between the ages of 18 and 40, with abroad array of primary diagnoses. Pilot results have indicated that the vast majority of subjects can be located in the community after release from the hospital and that the level of violence that is reported is ample for the purposes of statistical analysis (Steadman et al., 1993).

The risk factors we are investigating were chosen for both theoretical coherence and clinical utility. …

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