The Ethics of Paying Drug Users Who Participate in Research: A Review and Practical Recommendations

Abstract

THE PAYMENT OF RESEARCH PARTICIPANTS raises ethical and empirical questions that have special importance in addictions research involving drugdependent participants. Despite a now large literature on human subjects payment, what is still needed is practical guidance for investigators and ethics committees. This paper reviews the literature on: current payment practices and guidelines; defining features of undue and due incentives and fair reimbursement; and the significance of risks and harms that may arise from paying drug using participants. We conclude that research payments are ethically acceptable in most circumstances of addictions research, but should be closely scrutinized in situations where these may exacerbate existing harms or create additional risks for participants and investigators. General principles, key questions and procedural options are highlighted for an applied approach to ethical research payments. Future research directions are identified.

Research Participation and Internal Normativity: Understanding Why People Participate

“…citizenship, altruism, drug user activism). Such findings are corroborated in similar studies with different participant groups (Fry et al 2006;Mapstone et al 2007).…”

What Women Who Use Drugs Have to Say about Ethical Research: Findings of an Exploratory Qualitative Study

“…Key issues identified include the idea that such payments jeopardize informed consent by acting as an undue inducement, exploiting drug users' economic vulnerability and marginalization; some have also argued that paying drug users encourages and rewards illicit drug use (Fry & Dwyer, 2001;Buchanan et al, 2002;Ritter, Fry, & Swan, 2003;Sheldon, 2005;Fry et al, 2005Fry et al, , 2006.…”

“We’ve Been Researched to Death”: Exploring the Research Experiences of Urban Indigenous Peoples in Vancouver, Canada

“…Ethical considerations regarding incentivized research practices are particularly heightened when research concerns the involvement of vulnerable populations like those economically marginalized (Fry, Hall, Ritter, & Jenkinson, 2006;Head, 2009;Macklin, 1981;McNeill, 1997;Salmon et al, 2010). Arguments surrounding the ethical debate on the use of incentives in research with human subjects typically postulate whether incentives cause undue influence or serve as coercion to participate and compromise the dignity of the subject (Grant & Sugarman, 2004).…”