Healthy individuals who volunteer for medical research may do so as a means of earning part- or full-time income. However, in a discussion paper published in the Journal of Medical Ethics,1 researcher Joanna Różyńska, PhD, assistant professor, department of ethics, Institute of Philosophy, University of Warsaw, Poland, explains that clear moral distinctions exist between these healthy volunteers and people who are employed in unskilled labor jobs, particularly with regard to compensation. Greater consideration should be given to creating an ethical payment model for research participants that incorporates the risks, time investment, and activities that many volunteers expose themselves to on a regular basis.
There are 4 approaches to paying research volunteers: a market model, a wage-payment model, a reimbursement model, and an appreciation model. Previous researchers2,3 have argued for the wage-payment model, which guarantees a standardized hourly wage comparable to wages provided to unskilled workers.
Although this model is said to protect research participants from exploitation, some professionals in the research industry believe the services offered by healthy volunteers and unskilled laborers in other industries are not commensurate.
Volunteers for clinical research are “renting” out their bodies to discover how the human body reacts to a device, drug, or therapeutic strategy. Rather than being an active worker in an unskilled profession, they’re seen as passive subjects who are to be studied rather than individuals whose actions further advance the financial interests of a business.
The risks associated with being a research subject merit further consideration when developing a payment model for these individuals. According to Dr Różyńska, a risk-based payment model may be more appropriate for research participants, due to the bodily risks these individuals endure that are out of their control.
Many paid research subjects aren’t participating in studies in an effort to seek meaningful work, suggesting that “even an increase in social recognition of human guinea pigging will not transform the nature of the activity, which is more like renting out one’s body than making active use of it in order to perform certain tasks.”
- Różyńska J. What makes clinical labour different? The case of human guinea pigging [published online May 24, 2018]. J Med Ethics. doi:10.1136/medethics-2017-104267
- Dickert N, Grady C. What’s the price of a research subject? Approaches to payment for research participation. N Engl J Med. 1999;341:198-203.
- Grady C. Payment of clinical research subjects. J Clin Invest. 2005;15(7):1681-1687.