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Significant attention has been given both to the ethics of Controlled Human Infection Model (CHIM) research and the ethics of payment for research participation. However, comparatively little attention has been given to the ethics of paying for participation specifically in CHIM research. Grimwade et al (‘the authors’) should be commended for thoughtfully addressing this topic and especially for the empirical data collection informing their work, which is too often lacking in discussions of payment for research participation. In what follows I will discuss three relatively subtle factors that, I believe, make a difference to the ethical analysis of paying for research participation and raise what I intend to be constructive questions about the extent to which the survey instrument employed by the authors captures them.
The authors focus on payment for risk in CHIM research. They correctly stress that compensating participants for risk is controversial and that “many general guidelines warn against paying for the risk in medical research”. While not all guidance documents share this scepticism,1 compensating for risk raises thorny issues and uncertainty over the topic among IRBs (Institutional Review Boards) and regulatory bodies is likely to hinder the practice. Part of the difficulty in assessing payment for research risks stems from the way in which subtle variances in background assumptions influence the ethical assessment, which also complicates empirical attempts to measure attitudes on the topic.
Most importantly, it is crucial to be precise about background assumptions concerning whether participants are protected from bearing the financial burdens of research risks that eventuate in actual harms. Protective mechanisms …
Contributors I am the sole author of this work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.
↵Cf. OHRP, idem: 'IRBs should be cautious that payments are not so high that they create an ‘undue influence’ or offer undue inducement that could compromise a prospective subject’s examination and evaluation of the risks or affect the voluntariness of his or her choices.'