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May 1997

The Call of the Sirens: Navigating the Ethics of Medication-Free Research in Schizophrenia

Author Affiliations

Box 297 The New York Hospital-Cornell Medical Center 525 E 68th St New York, NY 10021
Charlottesville, Va

Arch Gen Psychiatry. 1997;54(5):415-416. doi:10.1001/archpsyc.1997.01830170031005

IN THE Odyssey, Odysseus directs his men to tie him to their ship's mast as they approach the mind-altering call of the Sirens.1 He forbids his crew to unlash him lest they all be destroyed and never reach their beloved Ithaca. Translated into a modern idiom, Odysseus outlines an advance directive for when he is decisionally incapacitated by the Sirens' seductions. He gives consent to his crew to bind and restrain him though he might ask for release.

See also pages 401 and 412

Addressing the ethics of medication-free research in schizophrenia, we can consider informed consent and protection of human subjects in light of this classical tale. Does the consent of a competent schizophrenic subject extend into a period of psychosis resulting from the agreed-upon drug-free interval? If consent is a process to be maintained over time,2 then how is ongoing voluntariness3 assured when the

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