Compensation and Reimbursement

2. Ethical Considerations

Payments in clinical trials have raised ethical concerns for many years. In 2005 Christine Grady (6) from the National Institutes of Health summarised the problem:

‘Several ethical concerns arise regarding the payment of research participants. The most commonly expressed concern is that payment could be coercive or serve as undue inducement to research participants. By definition, coercion is understood to involve a threat of physical, psychological, or social harm in order to compel an individual to do something, such as participate in research. However, money for research participation is an offer or an opportunity and not a threat and therefore cannot be perceived as coercion. But can money be considered an undue inducement? Existing guidelines warn against undue inducement and its potential to compromise informed consent, although there is disagreement about what exactly constitutes undue inducement and consequently disagreement about the extent to which it is a valid problem in research.’