CUREG 2.0

05. What preventive measures should be put in place for items related to suicidal ideations?

Including questions on suicidal ideations e.g., item 9 of the Beck Depression Inventory (BDI), is considered potentially problematic because the individual may declare suicidal thoughts or ideas, thus involving the ethical responsibility of the researchers (Green et al., 2015).

If suicidal ideations have been identified, researchers must refer the individual to the appropriate health authorities[1] (for a discussion of this issue see Hom et al., 2017). The solution recommended by the committee is to remove these questions (e.g., use the BDI excluding item 9). If this interferes with the research objectives, an intervention protocol must be created. See the model proposed by Carleton University

Examples are also available in Bailey et al. BMC Medical Ethics, 2020

Response anonymity or confidentiality does not absolve researchers of this responsibility. Where appropriate, a procedure for anonymization must be put in place after problematic cases have been identified. If those responsible for the research choose this option, the consent form should be modified. If the procedure does not allow for the identification of individuals (MTurk, Prolific, etc.), it would be appropriate to automate the receipt or display of an alert to the individual before they exit the application.

If your protocol does not directly address suicide, the solution recommended by the CUREG is to remove questions about suicidal ideations from the questionnaires or to use a measurement tool that does not contain a question related to suicide.

References

Bailey, E., Mühlmann, C., Rice, S. et al. Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey. BMC Med Ethics 21, 37 (2020). DOI: 10.1186/s12910-020-00479-1

Green, K. L., Brown, G. K., Jager-Hyman, S., Cha, J., Steer, R. A., & Beck, A. T. (2015). The predictive validity of the beck depression inventory suicide item. The Journal of clinical psychiatry, 76(12), 1683-1686.

Hom et al., 2017. Ethical issues and practical challenges in suicide research collaboration with institutional review boards. Crisis, 38, 107-114. DOI: 10.1027/0227-5910/a000415


[1] HUG Psychiatry Dept (Urgences secteur psychiatrique)

HUG Young Adults Psychiatry Dept (Unité psychiatrie du jeune adulte)

HUG Young Adult Health (Santé jeunes)

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