Should healthy volunteers in clinical trials be paid according to risk? Yes

doi:10.1136/bmj.b4142

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Eleri Jones, barrister1,
Kathleen Liddell, lecturer2

¹Middle Temple, London, EC4Y 9AT
²Faculty of Law, University of Cambridge, Cambridge CB3 9DZ

Correspondence to: E Jones eleri.jones{at}cantab.net

Eleri Jones and Kathleen Liddell argue that objections to paying according to risk are paternalistic, but John Saunders (doi:10.1136/bmj.b4145) thinks that it would lead to people being exposed to unacceptable danger

The severe reactions experienced by healthy volunteers in the TGN1412 (Northwick Park) trial have led to questions about payment for participation.1 Currently, the dominant view is that only time and expenses should be remunerated. By this logic a healthy volunteer participating in a half day trial at risk of immunological storm is paid the same as a volunteer participating in a half day observational study. This is objectionable for two reasons: firstly, because there should be recognition of a volunteer’s gift to society2 for the higher risks in some trials and, secondly, because it is inconsistent with other practices in society.

The law and current guidelines

The law allows volunteers to be paid subject to approval by a research ethics committee.3 In addition, the volunteer must give free and informed consent, yet there has been little judicial guidance on the influences, such as money, that render a …