I believe that in some cases it's ok, where in other cases it's not. In the case of a drug that required an IDE, it might be a good incentive just in case the patient may require additional treatments from undesired symptoms. If the treatment did not cause the desired affect or complications arise from the treatment, they should be compensated by the company that designed the drug. Compensation marketed as 'reward' could incentivize patients to sign the informed consent form because they know that complications arising from the treatment can be compensated for by the company.

Payment gives recognition to the participants' time and risks, which enhances the recruitment process, and boosts diversity. On the other hand, ethical concerns regarding coercion arise. Financial incentives may lead the most vulnerable people to participate in studies for the wrong reasons and ultimately weaken the principles of informed consent and understanding of risk. The lines separating voluntary participation from financial need may become blurred. 

While compensation may indeed facilitate trials, it needs to be carefully regulated. It should be done in such a way that ethical standards are compromised in no manner due to the financial incentives. The second aspect is balancing participant rights with research needs, which will ensure ethical conduct of the trial.

I think that Paying patients in clinical trials is ethical if it fairly compensates them for their time and risk. However, it can be problematic if high payments coerce vulnerable individuals to participate despite risks. The key is to balance fair compensation without undue influence or exploitation, ensuring participants' decisions are voluntary and informed

I think in most cases it is appropriate to offer patients in a clinical trial payment for their participation. Being involved in a clinical trial often involves time and travel of being treated and coming back for check-ups, which can inconvenience participants. At the very least, they should be compensated for time and travel spent on participating in the trial. In addition to this, for some longer studies participants may have to take days off work to travel to and from the testing site. If participants are not compensated, then this may reduce the diversity of the participant pool by placing hardships on people who may need to take off of work, which would limit the demographic of the pool. 

It is also worth considering that many clinical trials involve inherent risks, so compensation may be used to attract participants who might not be willing to assume these risks. For example, in the development of a new drug, the long-term effects may be unknown which makes participants hesitant to assume the risk. In this scenario, it is arguable that it is less ethical to persuade participants this way. A large determinate in deciding if payment falls under coercion or not is the amount of money being offered. If a study is offering what seems to be significantly more money than the amount that a participant may accumulate in their time and travel, then this is a red flag. This opens the risk for participants to go against their instincts or beliefs just for the money. This also can influence the demographic of patients in the opposite way as the previous scenario because now people are taking risks out of the need for money. This could compromise informed consent, as participants might prioritize compensation over understanding potential risks.

Coming back to read these responses, I agree with all of you. There are certain situations where it is ethical, but there are some that it is a flat out no. I personally think that the higher the risk, the better the reward for participation, the lower the risk, the lower the reward. With money, I think it is perfectly ethical to use as a reward because 1) everybody can use it, 2) can be given in different amounts in relation to the risk, and 3)could be very enticing to get more volunteers. I do believe there should be a written contract of informed consent for the procedure, the reward, and ability to pull out at any moment with loss/partial loss of the reward, where both parties sign and agree.

If patients are being rewarded for being tested on, the researcher may take advantage of them and perform unethical experiments. Patients have the right to leave the clinical trial whenever for whatever reason. If they receive an incentive to keep being in the study even if they don’t want to, that is a form of coercion. Patients should participate in clinical trials because they want to, not because they are being paid to do so.

Clinical experiments require human testing and this is usually done after preclinical trials have passed in animals and are deemed safe to perform on human testing. It is more involved than animal testing as it has more risks and precautions being taken. Not all answers come from animal testing and for running a trial for new pharmaceuticals, there has to be the correct dosage and measurements for humans. I believe patients in the trial should be rewarded for being tested on in the first place. Patients are basically putting their lives on the line for the trials, new pharmaceuticals, and medical devices in the long run. When testing, in most cases, it is the first clinical trial round, so they will essentially be the first humans to be testing the drug or vaccine which could have very serious risks. I also believe that it is ethical to give patients a “payment” for the use of their bodies. They are volunteering themselves and they know what they are getting into before it happens. This is all noted in the informed consent form for patients to read, agree to participate, input their information, and sign the form. Essentially without these clinical trials, we would not know how these new drug developments would interact with the human body. 

These scenarios are ethical to me and many of these clinical trials have rewarded patients for participating in their clinical research. For example, during the rise of COVID19, there were many clinical trials for the development of the COVID19 vaccine. Researchers were looking for an abundance of volunteers to test this vaccine. COVID was on the uprise and many people were affected by it, leading to a global pandemic and quarantine. Many people were dying to COVID and when you go outside, you must stay six feet away from others and stay masked up. Vaccines were developed, one from Pfizer and one from Moderna. They were in the late-stage clinical stages and needed volunteers to test the vaccines. Many people volunteered to test the vaccine just so they can contribute to helping reduce the risk of spreading COVID and to spend more time with their families during those times. During that time, these participants were receiving from $1,200 to $2,000 for completing the two-year study of the vaccine. This primary example is what I would deem as appropriate and ethical for rewarding patients for the use of their bodies. Of course, there are many risks for new drug and vaccine development, but if it will help them and everyone in the world with diseases like COVID19, then it is worth it. For me, it all depends on what the drugs are being treated for and what side effects are to be expected before I would agree to doing it. But if it is one that I believe in, I would do it if I was being rewarded for it. I do have to agree that patients who participate in the trials should want to be a part of it for the benefit of the healthcare world and not just for the money. They should not think that money is the number one reason to be a part of clinical research. They should look into what the clinical research is about, if it is safe to be in it or not, and if there are any catches or not. Patients should not be forced to partake in this if they do not want to as they are allowed to withdraw for whatever reason they have. Money should not be used to force someone to participate if they do not want to throughout the experiment.

I think they should be given payment because it is still a risk that they are choosing to take and there are of course possible benefits of partaking in the medication, but the risks of it being harmful are far greater. I do not think that the reward should be overly extravagant, but I do think that depending on the time that the person needs to put aside for completing the procedures that is how the payment should be decided. It is similar to the idea of Henrietta Lacks, her cells were stolen without her consent and then finally years later her family was given a payment for the usage. I believe there was a court case that decided that people should not be given a reward for donating their cells because it can hinder research because of the additional cost, however during the procedures to get those cells the person is not harmed. During these trials, the patient is willing to take a risk and for that risk there should be a benefit especially as the medication could simply not work on the person. I do think that even if no reward was offered people in dire need would probably still decide to partake in the research because it is solely for their benefit.

I think participants in pharmaceutical trials should receive compensation in some situations if it is ethical. The compensation should be based on the type of risk and time that the trial is. I think there should be a screening process to see if someone is vulnerable and doing the trial just because they need the money. I do think participants need to want to do the trial and not just for the compensation. Ethical compensation should reflect fairness, transparency, and voluntary participation.