Understanding What Participants in Empirical Bioethical Studies Mean: Historical Cautions From William James and Ludwig Wittgenstein

Abstract

Methods from psychology are informing much empirical research in bioethics by helping to understand the thoughts, feelings, and beliefs of people as they relate to a variety of bioethical issues. This can lead to improvements in practice or policy only if the subjective mental states under study have been characterized accurately. In this article, I describe two cautions from the history of psychology concerning the accurate characterization of mental states that have significant implications for how we elicit and interpret data in empirical bioethical studies. Both make reference to tendencies of mind that can be difficult to combat and that are the cause of other more specific methodological errors. The first historical caution, William James's “psychologist's fallacy,” warns against substituting the ethicist/researcher's point of view with that of the person under study. Failure to appreciate this essentially egocentric bias can result in asking people to report on things (e.g., probability of benefit from an experimental therapy) that are not a part of the person's experience in the same way they are a part of the researcher's worldview. The responses the person provides in such cases do not provide good information about his or her experience and so cannot be used to guide sound policy. The second historical caution is Wittgenstein's discursive perspective, which urges us to interpret the meaning of things said by a person in a research study by examining the function each utterance serves for the person. For example, one should avoid assuming that people respond to queries about understanding by simply describing their understanding. Instead, research participants might provide responses to achieve other goals, such as establishing a desired attitude in themselves. I suggest that both cautions can be addressed through careful qualitative investigation at the beginning of a research project.

Keywords:

• bioethics
• informed consent
• methodology
• applied psychology

ACKNOWLEDGMENTS

The author thanks the following colleagues who have informed the thoughts offered here: Alan Astrow, Neal Meropol, Kevin Schulman, Damon Seils, and Daniel Sulmasy. Thanks also to Alex Teng and Devon Check, who coded some of the qualitative data reported here.

Notes

Wittgenstein's Philosophical Investigations is written in a series of brief, numbered sections (denoted §). The convention is to cite the section number rather than the page number from a particular printing of the book.