Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Infect Dis. 2020 Jul 6;222(3):356-361. doi: 10.1093/infdis/jiaa284.
Trials are in development and underway to examine potential interventions for treatment and prophylaxis of coronavirus disease 2019 (COVID-19). How should we think about offering payment to participants in these trials? Payment for research participation is ethically contentious even under ideal circumstances. Here, we review 3 functions of research payment-reimbursement, compensation, and incentive-and identify heightened and novel ethical concerns in the context of a global pandemic. We argue that COVID-19 trial participants should usually be offered reimbursement for research-related expenses, and compensation for their time and effort, as for other types of research under usual circumstances. Given increased risk of undue influence against pandemic background conditions, incentive payment should be avoided unless essential to recruitment and retention in important trials whose social value outweighs this risk. Where essential, however, incentives can be ethically permissible, so long as reasonable efforts are made to minimize the possibility of undue influence.
正在开发和进行临床试验，以研究针对 2019 年冠状病毒病 (COVID-19) 的治疗和预防的潜在干预措施。我们应该如何考虑向这些试验的参与者提供报酬？即使在理想的情况下，研究报酬的支付在伦理上也存在争议。在这里，我们回顾了研究报酬的 3 种功能——报销、补偿和激励，并在全球大流行的背景下确定了新的、更突出的伦理问题。我们认为，在通常情况下，COVID-19 试验参与者通常应该获得与研究相关的费用报销，以及对他们的时间和精力的补偿，就像其他类型的研究一样。鉴于在大流行背景条件下不当影响的风险增加，除非在重要试验的招募和保留中必不可少，否则应避免激励性报酬，而这些试验的社会价值大于这种风险。然而，在必要的情况下，只要做出合理的努力将不当影响的可能性降到最低，激励措施在伦理上是可以允许的。
