payment of research subjects

Prevention of therapeutic misconception as a reason for payment of sick research participants
Ron L.P. Berghmans
Maastricht University
Department Health, Ethics & Society
PO Box 616
6200MD Maastricht
The Netherlands
+31433882145
r.berghmans@maastrichtuniversity.nl

Many medical researchers struggle to recruit patients for their next clinical trial. Patients are reluctant to enter clinical trials because because they prefer to stick with proven — though potentially inferior — treatments rather than trying something new (Nature 473, 433; 2011). This frustrates medical progress. Payment for participation might be a way to stimulate their willingness, but is ethically controversial. A major concern is that undue inducement results from financial incentives.

A major benefit of paying sick research subjects is the prevention of the so-called therapeutic misconception. This phenomenon appears when patients who decide about entering a clinical trial confuse medical treatment and medical research. They wrongly think that the primary or exclusive aim of the research is their personal therapeutic benefit. The therapeutic misconception threatens the moral validity of their consent (as potential undue inducement does). When payment is offered, it is to be expected that patients become less confused about the proper aim of the clinical trial. Thus the moral quality of their decision to participate increases. When payment is reasonable, concern over undue inducement can be reduced. Both are good reasons to motivate patients to participate in clinical trials by means of a financial incentive.


Reference:

Therapeutic success stifles medical progress. Nature 473, 433 (2011) doi:10.1038/473433a