Consider a scenario where, at the start of an appointment with a therapist, she explains to you that ‘the success of the therapy will depend on your own positive expectations, the respect and esteem that you have for me as a qualified health professional, the warm tone and empathic approach that I adopt towards you, and the trust that you place in me, during the course of treatment’. You might find this transparency about the therapeutic process to be refreshingly honest. (...) You might, however, be surprised if this openness turned out to be an ethical obligation that she owed you. Yet, for some commentators, this ‘open’ approach to psychotherapy – where there is openness about the common factors that can explain the efficacy of the therapy –is required by ethical standards of informed consent and respect for patient autonomy. In this edition of the Journal of Medical Ethics, Garson Leder formulates two responses to this type of ‘open therapy claim’: that ‘….informed consent does not require the practitioners ‘go open’ about the therapeutic common factors in psychotherapy, and clarity about the mechanism of change shows us …. (shrink)

Compared with mainstream medicine and complementary and alternative therapies, the practice of psychotherapy has enjoyed a relative pass when it comes to ethical evaluation. Therefore, contributions to the, although slowly growing, body of literature on psychotherapy ethics are to be welcomed. In his paper ‘Psychotherapy, placebos, and informed consent’, Garson Leder takes issue with what he calls the ‘go open’ project in psychotherapy ethics—the idea that the so-called ‘common factors’ in therapy should be disclosed to prospective patients. Although Leder does (...) not give a detailed list, the common factors include therapist characteristics, patient characteristics, and the working alliance. He argues that the project advocating disclosure of these factors is flawed on two grounds: that information about common factors is not necessary for informed consent; and clarity about specific mechanisms of change in therapy is consistent with ‘many theory-specific forms of psychotherapy’. There are multiple serious problems with Leder’s critique of the recent literature, including how he represents the contours of the debate, which I list, and address in this response. (shrink)

Deception in research is contentious, as ethical codes stress informed consent, yet complete disclosure may jeopardise validity. Indian Council for Medical Research (ICMR) guidelines classify deception into active, incomplete, and authorised forms. This study explores the ethical justification for incomplete (partial disclosure), permissible instances, and the dilemma faced by ethics committees in balancing scientific rigour and participant protection. The qualitative, non-experimental cross-sectional research, using in-depth interviews, identifies themes through thematic analysis. Findings reveal challenges for ethics committees, as incomplete information hampers (...) understanding, amongst others. The paper proposes an ethics committee framework, urging researchers to minimise or avoid partial deception and recommending institutional awareness campaigns and standard operating procedures for minimal-harm studies using partial disclosure. Therefore, it proposes that partial disclosure should be justified by the 3Vs—value, validity, and veracity to preserve research integrity. (shrink)