Andrew Markus Lecture: Money, Money, Money - Ethical Issues with Paying Patients and Research Participants

Monetary payments to patients to adopt healthy behaviors and monetary payments to prospective research subjects to encourage participation in research raise complex ethical issues. One major ethical concern is that these monetary payments imperil voluntary choice by creating “undue influence” whereby the patient and/or prospective research participant can no longer make a rational choice. This paper argues that “undue influence” concerns brought about by monetary payments likely do not exist either in clinical care or research. Furthermore, in the unlikely event that proof of “undue influence” could be empirically demonstrated, ethical concerns over exploitation and discrimination so greatly outweigh concerns over undue influence that this concept should be wholly abandoned.