with considering “whether payment (financial or otherwise) may be made to a child, parent, guardian, or legally authorized representative for the participation of the child in research.” This chapter describes the different kinds of payments offered to parents and children, reviews the ethical concerns about such payments, and describes the regulations or guidance provided by federal agencies and others to investigators, institutional review boards (IRBs), and sponsors of research. It also reviews the very limited literature on the use and effects of payments and other incentives. Although they are not payments for research participation as such, the chapter also considers policies and practices on compensation to participants for research-related injuries and payments to physicians for recruiting children to clinical studies.

TYPES OF PAYMENTS RELATED TO RESEARCH PARTICIPATION

Wendler and colleagues (2002) have distinguished four types of payment related to participation in research:

  • reimbursements for expenses (e.g., parking or bus fare);

  • compensation for the time and inconvenience involved in research participation (e.g., payment at minimum wage for some or all of the hours required of a research participant);

  • appreciation payments at token levels (e.g., $25, toys, gift certificates, or movie coupons); and

  • incentive payments that offer amounts for participation in research that are not limited to reimbursement, compensation, or token levels.

The committee found the above categories helpful in distinguishing differences among types of payments and discussing payment practices that may unduly influence decisions about research participation. Often, however, research protocols lump payments into one sum, which can make it difficult to determine whether a payment (and how much of payment) is intended to reimburse expenses, compensate for time, express appreciation, or provide an additional incentive for research participation. An explicit identification of the purpose of a payment may help investigators and IRBs evaluate that purpose and also consider reasonable variations in payment practices or amounts, including those that arise from differences in research sites. For example, parking expenses for a 2-hour research visit at a city hospital could run more than $20, whereas parking at a suburban hospital might be free.

For purposes of this report, “nonfinancial payments” include gifts such as toys, computer games, and books. Gifts are usually—but not always—nominal in value and are typically given as tokens of appreciation. Other



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