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Arch Gen Psychiatry. 1999;56:703-704.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

WE appreciate the 3 thoughtful commentaries on our response to the report of the National Bioethics Advisory Commission (NBAC) and we comment on each in turn.

Miller and Fins agree with our concerns about the impediments to psychiatric research that could result if new regulations emerged based on the NBAC's recommendations to establish only 2 categories of research risk. Regarding our concerns about the stigmatizing nature of the scope of the report, they suggest that we do not provide "any explicit, cogent argument," adding that in their view the recommendations are not stigmatizing if they provide appropriate protections for the research participants in question. We certainly agree that appropriate protections are not stigmatizing, and we argued that such protections should apply to all incapacitated subjects. Miller and Fins, however, then describe how the NBAC's recommendations might indeed be stigmatizing, eg, by requiring independent capacity assessment for research in the more . . . [Full Text of this Article]

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