A Penny for Your Thoughts? Moving Research Payment Transparency from Idiom to Policy.

Payment for participation in research—especially clinical research—is a common practice, but researchers often find themselves working in a “black hole” regarding payment. There are no well-described standards for decision-making on payment amounts and forms of payment, apart from the Belmont Report’s abstract warnings against exerting “coercion and undue influence” (HHS, 1979). Without tools to support decision-making in this area, payment decision practices tend to be subjective and based on personal experience; researchers with no experience in this area may make payment decisions for research participation based on available funds, personal notions, and guesswork of “what’s best.” Nonetheless, the authors know from personal experience that payment decisions can significantly impact studies at each step of the CONSORT process, from screening and enrollment to condition allocation and retention and, ultimately, data analysis and reporting (Altman et al., 2001). Emerging data on payment decision-making—although still limited—reveals a complex web of factors that drive payment amounts, including participant type, proximity to the study site, risks involved, procedure invasiveness, and the expectations of research participants themselves, which may be based on their experiences in other studies. Given the potential influence of these myriad factors on study participation, it is therefore surprising that to date there has been a relative absence of attention and transparency on what, how, when, and by whom participant payments are determined (Anderson and Brown, 2021). The prevailing worry about participant payments is that they could be coercive or cause undue influence on participants’ decisions to participate in research or undertake certain study procedures. More recently, however, ethicists have moved away from this paradigm to focus on the opposite issue: underpayment of people who participate in research, and the ethical principle of beneficence (Largent and Lynch, 2017). Although ethics committees do not typically consider payment in the risk/benefit ratio when reviewing research, participants may view payment as another benefit of research participation. Progress in the Science of Participant Payment