Research Ethics: Depression and Mortality in Nursing Homes

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Abstract
To the Editor. —The recent article by Rovner et al1 on depression and mortality in nursing homes raises important ethical issues concerning the conduct of research in nursing homes. Rovner et al report on the prevalence of major depressive disorder in residents newly admitted to eight nursing homes between February 1987 and March 1988. The investigators interviewed the residents and determined if they met the criteria for major depressive disorder, but they apparently did not divulge this information to the staff caring for the residents. Only 14.3% of the residents with depression had this diagnosis made by the nursing home physicians, and only 21.1% received antidepressant treatment. We assume that the remainder of the residents went untreated for the course of the study and continued to suffer from depression while being observed. Our primary question centers on how the researchers justified not revealing the diagnosis of depression to the

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