On Gnats, Camels and Payment to Research Subjects: A Commentary

Abstract

Lainie Friedman Ross refreshingly challenges the acceptedwisdom that there is some intrinsic wrong in compensating adult subjects for panicipating in nontherapeutic research and something even worse about compensating children (or, by implication, other incompetent subjects) whose panicipation depends on surrogate consent. Notwithstanding the clarity ofher reasoning and the underlying boldness of her essay, however, something stopped Dr. Ross shon of advocating complete revision ofthe conventional prohibitions. "The offer ofmoney" she says, "becomes morally objectionable if it gives ... an incentive to take a risk that one would not otherwise take." Opponents ofany compensation might readily argue that this formulation is too sponge-like to give any guidance for distinguishing between objectionable and unobjectionable compensation--except perhaps to permit compensation for out-ofpocket expenses, such as travel costs. But that is not my concern with Dr. Ross's formulation. My concern-my puzzlement, to be more precise- is in identifying exactly what is wrong with payment that provides an incentive to accept risks that would otherwise not be taken.