Inducement in research

Bioethics

Volumn 11, Issue 5, 1997, Pages 373-389

  Wilkinson, Martin ^a   Moore, Andrew ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ANALYTICAL APPROACH; ARTICLE; BIOMEDICAL AND BEHAVIORAL RESEARCH; ETHICS; FEE; FREEDOM; HUMAN; HUMAN EXPERIMENT; INFORMED CONSENT; MOTIVATION; PATERNALISM; PATIENT SELECTION; PERSONAL AUTONOMY; PERSUASIVE COMMUNICATION; POVERTY; PRACTICE GUIDELINE; PROFESSIONAL STANDARD; RESEARCH SUBJECT; RISK; RISK ASSESSMENT; SCIENCE; VOLUNTARY WORKER;

ANALYTICAL APPROACH; BIOMEDICAL AND BEHAVIORAL RESEARCH;

COERCION; ETHICS; ETHICS COMMITTEES; ETHICS COMMITTEES, RESEARCH; FEES AND CHARGES; FREEDOM; GUIDELINES; HUMAN EXPERIMENTATION; HUMANS; INFORMED CONSENT; MOTIVATION; NONTHERAPEUTIC HUMAN EXPERIMENTATION; PATERNALISM; PATIENT SELECTION; PERSONAL AUTONOMY; POVERTY; RESEARCH SUBJECTS; RISK; RISK ASSESSMENT; SCIENCE; VOLUNTARY WORKERS;

EID: 0031241981     PISSN: 02699702     EISSN: None     Source Type: Journal    
DOI: 10.1111/1467-8519.00078     Document Type: Article

References (35)

1. We are grateful to Jo Asscher, Andrew Brien, Alison Douglass, Tim Mulgan, Nicola Peart, Andrew Williams, the members of the Southern Regional Health Authority Ethics Committee (Otago), two referees, and participants in the University of Otago's Philosophy Department Seminar, Bioethics Research Centre Journals Club, and Bioethics Summer School 1996, for helpful comments.
2. We prefer the term 'subjects' to 'participants'. The latter term is ambiguous between researchers and research subjects.
3. Health Research Council of New Zealand (HRC), Guidelines for Ethics Committees, 6.3.2.1 (iii). The HRC Ethics Committee is the accrediting body for many ethics committees in New Zealand.
4. National Health and Medical Research Council of Australia, NHMRC Statement on human experimentation, 1992, 13.
5. Food and Drug Administration, FDA Information Sheet: Payment to Research Subjects, Rockville, United States, 1988.
6. Council for International Organizations of Medical Sciences, International Ethical Guidelines for Biomedical Research Involving Human Subjects, Guideline 4. The orthodoxy is very similar in Britain. See Manual for Research Ethics Committees, compiled by C. Foster, Centre of Medical Law and Ethics, Kings College, London, December 1994. Section II.49 of this document quotes numerous statements against inducement payments to research subjects from the guidelines of the Department of Health, the Royal College of Physicians, the General Medical Council, the Association of British Pharmaceutical Industries, the British Psychological Society, and the National Union of Students.
7. Council for International Organizations of Medical Sciences, International Ethical Guidelines for Biomedical Research Involving Human Subjects, Guideline 4. The orthodoxy is very similar in Britain. See Manual for Research Ethics Committees, compiled by C. Foster, Centre of Medical Law and Ethics, Kings College, London, December 1994. Section II.49 of this document quotes numerous statements against inducement payments to research subjects from the guidelines of the Department of Health, the Royal College of Physicians, the General Medical Council, the Association of British Pharmaceutical Industries, the British Psychological Society, and the National Union of Students.
8. It is hard to reconcile rejection of inducements with acceptance of payment for inconvenience, time spent, and out-of-pocket expenses, since these all increase the probability of participation. Perhaps the guideline writers rely on a distinction between due and undue inducement. If so, the rest of our discussion may be treated as an inquiry into whether there can be any undue inducement in research.
9. We also leave aside the question of what should be done, in the context of inducement, when subjects wish to withdraw during a study.
10. R. Faden and T. Beauchamp, A History and Theory of Informed Consent, New York: Oxford University Press, 1986, p. 358.
11. P. McNeill, The Ethics and Politics of Human Experimentation, Cambridge: Cambridge University Press, 1993, p. 176.
12. See the evidence cited by McNeill, p. 176.
13. The claim that freedom requires a plurality of acceptable options is controversial. For its denial, see H. Steiner, An Essay on Rights, Oxford: Blackwell, 1994, pp. 10-21. We adopt this controversial claim because it generates more difficulties for our argument than does its rejection.
14. See, for example, Faden and Beauchamp, pp. 344-5 and, for exhaustive discussion of the subtleties, J. Feinberg, Harm to Self, New York: Oxford University Press, 1986.
15. For a summary of the large and rather baroque literature on coercive offers, see Feinberg, ch. 24.
16. It might still be an exploitative offer. We discuss exploitation in Section 4.
17. Faden and Beauchamp bizarrely overlook this point, and their own freedom/ autonomy distinction, in their confusing discussion of welcome and unwelcome offers. That discussion is an attempt to salvage their view that inducements undermine the autonomy of the poverty-stricken woman mentioned earlier. See their pp. 358-9.
18. In their discussion of the infamous Tuskegee syphilis experiment, Faden and Beauchamp seem to suggest that the researchers used money as a blind to persuade would-be subjects not to consider the matter properly. See their pp. 165, 356.
19. See Feinberg, pp. 118-121.
20. For one special case in which this argument can perhaps be made, see Section 5.
21. For valuable and sceptical discussion of the idea of exploitation as theft of labour product, see P. van Parijs, Real Freedom For All (Oxford, 1995), ch. 5; and G. Cohen, Self-Ownership, Freedom, and Equality (Cambridge, 1995), ch. 6.
22. For valuable and sceptical discussion of the idea of exploitation as theft of labour product, see P. van Parijs, Real Freedom For All (Oxford, 1995), ch. 5; and G. Cohen, Self-Ownership, Freedom, and Equality (Cambridge, 1995), ch. 6.
23. A. Wood, 'Exploitation', Social Philosophy and Policy, 1995, p. 147.
24. Wood, pp. 147-9.
25. Wood, pp. 150-1.
26. Note that exploitation is avoided if the non-poor are the only subjects paid. This can be done by making poverty an exclusion criterion for research subjects. We assume, however, that this is objectionable on other grounds.
27. For a sample of the large literature on these topics, see T. Nagel, The View From Nowhere, New York and Oxford: Oxford University Press, 1986, especially ch. IX; S. Scheffler, The Rejection of Consequentialism, Oxford: Clarendon Press, 1982; D. Parfit, Reasons and Persons, Oxford: Clarendon Press, 1984, section 57; S. Kagan, The Limits of Morality, Oxford: Clarendon Press, 1989; J. Dancy, 'Agent-relativity - the very idea', in R. Frey and C. Morris (eds.), Value, Welfare, and Morality, New York and Cambridge: Cambridge University Press, 1993; and C. Korsgaard, 'The reasons we can share', in E. Paul and F. Miller (eds.) Altruism, New York and London: Cambridge University Press, 1993.
28. For a sample of the large literature on these topics, see T. Nagel, The View From Nowhere, New York and Oxford: Oxford University Press, 1986, especially ch. IX; S. Scheffler, The Rejection of Consequentialism, Oxford: Clarendon Press, 1982; D. Parfit, Reasons and Persons, Oxford: Clarendon Press, 1984, section 57; S. Kagan, The Limits of Morality, Oxford: Clarendon Press, 1989; J. Dancy, 'Agent-relativity - the very idea', in R. Frey and C. Morris (eds.), Value, Welfare, and Morality, New York and Cambridge: Cambridge University Press, 1993; and C. Korsgaard, 'The reasons we can share', in E. Paul and F. Miller (eds.) Altruism, New York and London: Cambridge University Press, 1993.
29. For a sample of the large literature on these topics, see T. Nagel, The View From Nowhere, New York and Oxford: Oxford University Press, 1986, especially ch. IX; S. Scheffler, The Rejection of Consequentialism, Oxford: Clarendon Press, 1982; D. Parfit, Reasons and Persons, Oxford: Clarendon Press, 1984, section 57; S. Kagan, The Limits of Morality, Oxford: Clarendon Press, 1989; J. Dancy, 'Agent-relativity - the very idea', in R. Frey and C. Morris (eds.), Value, Welfare, and Morality, New York and Cambridge: Cambridge University Press, 1993; and C. Korsgaard, 'The reasons we can share', in E. Paul and F. Miller (eds.) Altruism, New York and London: Cambridge University Press, 1993.
30. For a sample of the large literature on these topics, see T. Nagel, The View From Nowhere, New York and Oxford: Oxford University Press, 1986, especially ch. IX; S. Scheffler, The Rejection of Consequentialism, Oxford: Clarendon Press, 1982; D. Parfit, Reasons and Persons, Oxford: Clarendon Press, 1984, section 57; S. Kagan, The Limits of Morality, Oxford: Clarendon Press, 1989; J. Dancy, 'Agent-relativity - the very idea', in R. Frey and C. Morris (eds.), Value, Welfare, and Morality, New York and Cambridge: Cambridge University Press, 1993; and C. Korsgaard, 'The reasons we can share', in E. Paul and F. Miller (eds.) Altruism, New York and London: Cambridge University Press, 1993.
31. For a sample of the large literature on these topics, see T. Nagel, The View From Nowhere, New York and Oxford: Oxford University Press, 1986, especially ch. IX; S. Scheffler, The Rejection of Consequentialism, Oxford: Clarendon Press, 1982; D. Parfit, Reasons and Persons, Oxford: Clarendon Press, 1984, section 57; S. Kagan, The Limits of Morality, Oxford: Clarendon Press, 1989; J. Dancy, 'Agent-relativity - the very idea', in R. Frey and C. Morris (eds.), Value, Welfare, and Morality, New York and Cambridge: Cambridge University Press, 1993; and C. Korsgaard, 'The reasons we can share', in E. Paul and F. Miller (eds.) Altruism, New York and London: Cambridge University Press, 1993.
32. For a sample of the large literature on these topics, see T. Nagel, The View From Nowhere, New York and Oxford: Oxford University Press, 1986, especially ch. IX; S. Scheffler, The Rejection of Consequentialism, Oxford: Clarendon Press, 1982; D. Parfit, Reasons and Persons, Oxford: Clarendon Press, 1984, section 57; S. Kagan, The Limits of Morality, Oxford: Clarendon Press, 1989; J. Dancy, 'Agent-relativity - the very idea', in R. Frey and C. Morris (eds.), Value, Welfare, and Morality, New York and Cambridge: Cambridge University Press, 1993; and C. Korsgaard, 'The reasons we can share', in E. Paul and F. Miller (eds.) Altruism, New York and London: Cambridge University Press, 1993.
33. Wood, p. 156.
34. Wood, p. 153.
35. One further argument for the inference from bad science to bad ethics appeals to the waste of researcher time and money it involves. This issue need trouble only researchers themselves, and their funding bodies.