In this paper some of the general issues surrounding recently published guidelines for the practice of research ethics committees are outlined, concentrating in particular on the difficulties raised by research with psychiatric patients. Research is distinguished from ordinary clinical practice by the intention to advance knowledge. So defined, research with psychiatric patients should be governed by the same four principles as research with any other group--knowledge, necessity, benefit and consent. In applying these principles, however, particularly the principle of consent, many (...) acute difficulties are raised by psychiatric patients. A number of proposals for addressing these difficulties are discussed. It is suggested that, notwithstanding the value of published guidelines, and the help that may be available from research ethics committees, the primary responsibility for maintaining high standards of practice in research rests with research workers themselves. (shrink)

tries to elucidate some of the rational considerations that determine the standing and value of psychoanalysis. He is sceptical about much of the positive evidence, but he also tries to provide some support for Freudian doctrines. I examine his supporting arguments and try to show that they have serious weaknesses.

This book critically examines Freud's own detailed arguments for his major explanatory and therapeutic principles, the current neorevisionist versions of psychoanalysis, and the hermeneuticists' reconstruction of Freud's theory and therapy as an alternative to what they claim was a “scientistic” misconstrual of the psychoanalytic enterprise. The clinical case for Freud's cornerstone theory of repression – the claim that psychic conflict plays a causal role in producing neuroses, dreams, and bungled actions – turns out to be ill-founded for two main reasons: (...) Even if clinical data were valid, the method of free association has failed to support the psychoanalytic theory of unconscious motivation; Clinical data tend in any case to be artifacts of the analyst's self-fulfilling expectations, thus losing much of their evidential value. The hypothesis that psychoanalytic treatment is in reality a placebo poses a serious challenge to the assumption that insight is a key causal factor when therapy is successful. This challenge has yet to be met by psychoanalysts. Similar conclusions undermine the neorevisionist versions of psychoanalysis. The most influential hermeneuticists, on the other hand, are shown to have imposed an alien philosophy on psychoanalysis, partly through their reliance on gross misconceptions of the natural sciences. Karl Popper's criticism of the Freudian corpus as empirically untestable has misjudged its evidential weaknesses, which are more subtle. If there exists empirical evidence for the principal psychoanalytic doctrines, it cannot be obtained without well-designed extraclinical studies of a kind that have for the most part yet to be attempted. (shrink)