Ethics of undisclosed payments to doctors recruiting patients in clinical trials

BMJ 2002; 325 doi: http://dx.doi.org/10.1136/bmj.325.7354.36 (Published 6 July 2002)
Cite this as: BMJ 2002;325:36.1

Get access to this article and all of bmj.com for the next 14 days

Sign up for a 14 day free trial today

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

  1. Jammi N Rao, chairman (jammi@bharat.demon.co.uk)a,
  2. L J Sant Cassia, chairmanb
  1. aWest Midlands Multicentre Research Ethics Committee, 27 Highfield Road, Birmingham B15 3DP
  2. bCoventry Research Ethics Committee, University Hospitals Coventry NHS Trust, Coventry CV2 2DX
  1. Correspondence to: Dr Rao

    Financial advisers who sell you insurance or mortgages are required by the rules to tell you how much commission they will earn as a result of your custom. But doctors who ask patients under their care to take part in a clinical trial are under no obligation to reveal how much they might earn as a result of their patients agreeing to take part in the trial. Can this be right?

    Of course, the situation is not quite as simple as this. Selling insurance, one could argue, is not the same as inviting a patient to take part in a clinical trial. If the doctor was not reimbursed generously for his time then important clinical research would just not get done.1 The doctor can be trusted to put the best interests of the patient above personal gain, and therefore telling potential trial subjects how much the doctor will be paid is unnecessary. Do these arguments stand up to closer scrutiny? Or has the practice and scale of payments reached a point where it has become harmful to the conduct of good research?

    Randomised clinical trials, often sponsored by pharmaceutical companies with a valid commercial as much as a genuinely scientific interest, are the only reliable way to generate good quality evidence of efficacy.2 Clinicians ideally should be in equipoise about the treatments being tested,3 and patients should give voluntary consent based on full disclosure …

    Get access to this article and all of bmj.com for the next 14 days

    Sign up for a 14 day free trial today

    Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

    Article access

    Article access for 1 day

    Purchase this article for £20 $30 €32*

    The PDF version can be downloaded as your personal record

    * Prices do not include VAT

    THIS WEEK'S POLL