A Passing Problem: Evaluating Harm and Benefit in Autism Research

Author:

Ne'eman Ari1,Richman Kenneth A.2,McCarthy Allison M.3,Wilkenfeld Daniel4

Affiliation:

1. PhD candidate in health policy at Harvard University

2. Professor of philosophy and health care ethics at the Massachusetts College of Pharmacy and Health Sciences (officially known as MCPHS University)

3. Assistant professor of psychiatry and behavioral sciences and a faculty member with the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center

4. Associate professor in the Department of Acute and Tertiary Care in the School of Nursing at the University of Pittsburgh

Abstract

ABSTRACTAutism research frequently seeks to evaluate interventions or inform their development. Unfortunately, researchers often assume that autism intervention should reduce autistic traits, effectively setting as a goal of treatment that autistic people attempt to “pass” as nonautistic. A growing body of evidence highlights serious potential harms from passing demands. We discuss why it is important for institutional review boards (IRBs) to scrutinize autism research for clinical passing demands, and we document the existence of such demands in outcome measures commonly employed in autism research. We propose an ethical framework for IRBs and others to make use of in evaluating the ethical appropriateness of particular treatment goals in autism intervention or intervention‐adjacent research, emphasizing that treatment goals should be in pursuit of a beneficial nonpassing purpose and be the least burdensome means of accomplishing such a purpose. We also highlight potential promising practices for IRBs, investigators, and other stakeholders seeking to address these issues in autism research.

Funder

National Institutes of Health

Publisher

Wiley

Subject

Health (social science)

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