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Education versus screening: the use of capacity to consent tools in psychiatric genomics
  1. Camillia Kong1,
  2. Mehret Efrem2,
  3. Megan Campbell3
  1. 1 School of Law, Birkbeck University of London Institute for Criminal Policy Research, School of Law, London, UK
  2. 2 Department of Psychiatry, University of Oxford, Oxford, UK
  3. 3 Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  1. Correspondence to Dr Camillia Kong,Birkbeck University of London Institute for Criminal Policy Research, London, UK; camillia.kong{at}


Informed consent procedures for participation in psychiatric genomics research among individuals with mental disorder and intellectual disability can often be unclear, particularly because the underlying ethos guiding consent tools reflects a core ethical tension between safeguarding and inclusion. This tension reflects important debates around the function of consent tools, as well as the contested legitimacy of decision-making capacity thresholds to screen potentially vulnerable participants. Drawing on human rights, person-centred psychiatry and supported decision-making, this paper problematises the use of consent procedures as screening tools in psychiatric genomics studies, particularly as increasing normative emphasis has shifted towards the empowerment and participation of those with mental disorder and intellectual disabilities. We expound on core aspects of supported decision-making, such as relational autonomy and hermeneutic competence, to orient consent procedures towards a more educative, participatory framework that is better aligned with developments in disability studies. The paper concludes with an acknowledgement of the pragmatic and substantive challenges in adopting this framework in psychiatric genomics studies if this participatory ethos towards persons with mental disorder and intellectual disability is to be fully realised.

  • informed consent
  • capacity
  • mentally ill and disabled persons
  • genetic screening/testing

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  • Contributors All three authors contributed to the conceptualisation and first draft of the paper. CK and MC were responsible for subsequent drafts and edits to the paper.

  • Funding Funding for the research of the paper was provided by the NeuroGenE project, funded by the Broad Institute of MIT and Harvard.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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