City of Hope Comprehensive Cancer Center, Duarte, California, USA.
J Law Med Ethics. 2011 Fall;39(3):543-58. doi: 10.1111/j.1748-720X.2011.00621.x.
Both international and federal regulations exist to ensure that scientists perform research on human subjects in an environment free of coercion and in which the benefits of the research are commensurate with the risks involved. Ensuring that these conditions hold is difficult, and perhaps even more so when protocols include the issue of monetary compensation of research subjects. The morality of paying human research subjects has been hotly debated for over 40 years, and the grounds for this debate have ranged from discussion of legal rights, economic rights, philosophical principles of vulnerability and altruism to bioethical concepts of consent, best-interest determination, and justice theory. However, the thought surrounding these issues has evolved over time, and the way we think about the role of the human research subject today is markedly different than the way we thought in the past. Society first thought of the research subject as an altruist, necessarily giving of his time to benefit society as a whole. As time progressed, many suggested that the subject should not need to sacrifice himself for research: if something goes wrong, someone should compensate the subject for injuries. The concept of redress evolved into a system in which subjects were offered money as an inducement to participate in research, sometimes merely to offset the monetary costs of participation, but sometimes even to mitigate the risks of the study. This article examines ethical and legal conversations regarding compensation from the 1960s through today, examining theories of the ethics of compensation both comparatively and critically. In conclusion, we put forward an ethical framework for treating paid research subjects, with an attempt to use this framework as a means of resolving some of the more difficult problems with paying human subjects in research.
国际和联邦法规的存在，是为了确保科学家在没有胁迫的环境中对人类进行研究，并且研究的收益与所涉及的风险相称。确保这些条件得到满足是困难的，尤其是当方案包括对研究对象进行金钱补偿时。支付人类研究对象报酬的道德问题已经争论了 40 多年，争论的理由从法律权利、经济权利、易受伤害和利他主义的哲学原则到同意、最佳利益确定和正义理论等生物伦理概念。然而，随着时间的推移，围绕这些问题的思考已经发生了演变，我们今天对人类研究对象角色的看法与过去大不相同。社会最初将研究对象视为利他主义者，他必然会牺牲自己的时间来造福整个社会。随着时间的推移，许多人认为，研究对象不应该为了研究而牺牲自己：如果出现问题，应该有人为研究对象的伤害赔偿。赔偿的概念演变成了一个制度，研究对象可以获得金钱作为参与研究的诱因，有时只是为了抵消参与的经济成本，但有时甚至是为了减轻研究的风险。本文通过比较和批判性地审查补偿的伦理和法律讨论，考察了从 20 世纪 60 年代到今天的补偿伦理理论。最后，我们提出了一个对待付费研究对象的伦理框架，试图利用这个框架来解决一些在研究中支付人类对象的更困难问题。
