The ethical context in which geropsychiatric research is carried out today in the United States has its origins in events of the 1960s and 1970s. Three main trends can be identified. The first is sociopolitical and involves the challenge to tradition and authority manifested in that period with its consequent moral pluralism and focus on new forms of individualism. Ethical thinkers redirected their attention to more normative questions and moral problems in medicine came under close scruitiny. Regulatory changes affecting research followed. The second trend greatly influenced the type of research that would predominate in psychiatry after the mid-1970s. This trend involved the redirection of psychiatric thinking towards renewed interest in psychopathology, nosology and quantitation which was dormant during the preceding psychodynamically oriented decades. The final trend was the aging of the American population. Whereas before the 1960s there was little interest in aging the age-related neuropsychiatric conditions, subsequent decades ushered in much interest and support for human aging research. New moral problems have naturally arisen. Most of them have involved vulnerable subpopulations of elderly. Nontheless, whiIe small areas of disagreement remain and regulation is incomplete, research in geriatric psychiatry now proceeds within a well-structured context of ethical guidelines and government regulations.
KEY woms-Geriatric psychiatry, research, ethics.
PRELUDE TO CHANGE
Just 30 years ago medical research on aging stimulated little interest in the United States and human research in general lacked well-defined or agreed upon ethical guidelines and regulations. In order to understand the transformation of the ethical forces that now influence research in geriatric psychiatry it is worthwhile to begin by recalling the social and political zeitgeist of the previous generation when the seeds of change were sown. From a moral perspective, the 1960s and 1970s were iconoclastic. Diverse groups in society, long ignored, repressed or taken for granted, began to assert their individuality, quest for legitimacy and demand their rights. Differences in values with traditional America became striking. It was a time of confrontation and challenge to tradition and authority from which a morally more diverse America was struggling to emerge.