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A Living Wage for Research Subjects

Published online by Cambridge University Press:  01 January 2021

Extract

Offering cash payments to research subjects is a common recruiting method, but this practice continues to be controversial because of its potential to compromise the protection of human subjects. Some critics question whether researchers should be allowed to offer money at all, citing concerns about commodification of the research subject, invalidation of study results, and increased risks to subjects. Other critics are comfortable with the idea of monetary payments but question how much researchers can pay their subjects, citing concerns about undue inducement, crowding out, and monetary exploitation. Focusing only on the amount researchers can pay their subjects, this paper argues that the federal regulations and guidelines should implement a standard payment formula. It argues for a wage payment model, and critically examines three candidates for a base wage: the nonfarm production wage, the FLSA minimum wage, and a living wage.

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Independent
Copyright
Copyright © American Society of Law, Medicine and Ethics 2011

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References

Critics used to worry that offers of money would compromise the voluntariness of consent, but this concern about coercion has recently been put to rest. For more, see Wertheimer, A. and Miller, F., “Payment for Research Participation: A Coercive Offer?” Journal of Medical Ethics 34, no. 5 (2009): 389392.CrossRefGoogle Scholar
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The studies have been challenged on at least three bases: (1) Bentley and Thacker's subjects were pharmacy student who had greater than average experience with clinical trials, which may have biased the sample in this study; (2) the largest payment tested in either study was $2000, which limits the scope of the findings; and (3) the studies recorded only hypothetical willingness to participate, which is different in important respects from actual willingness to participate, which challenges the ability of the study to answer the question of whether large payments are actually unduly inducive. For more on (1) and (2), see Ballantyne, A., “Benefits to Research Subjects in International Trials: Do They Reduce Exploitation or Increase Undue Inducement?” Developing World Bioethics 8, no. 3 (2008): 178191; for more on (3) see Phillips, , supra note 5.CrossRefGoogle Scholar
While the Bentley and Thacker and the Halpern et al. studies showed that common payment amounts did not unduly induce potential subjects, we really do not know much about undue inducement. For example, we do not know whether it is a binary concept or a concept that admits of degrees. It could be that all payments beyond a certain threshold are equally unduly inducing and all payments below the threshold are equally non-unduly inducing; or it could be that payments are more or less inducing depending on the amount. Also, we do not know whether undue inducement, if it exists at all, is objective or subjective. It could be that any given payment is unduly inducing for some people but not others, or unduly inducing for some studies but not others. In any case, it is safe to assume that if undue inducement does indeed exist, then minimizing the amount of a payment will minimize the likelihood that the payment will be unduly inducing. See Bentley, and Thacker, , supra note 58; and Halpern, et al., supra note 56.Google Scholar
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