While participating in a recent training on human subject protection in research, I was struck by one topic that I would not have normally thought of as a thorny ethical dilemma. In our experience, incentives are usually determined by a balance of the resources an organization can give with what we (the researcher and the organization together) believe will encourage people to participate.

As we have described in a recent newsletter article (http://www.theimprovegroup.com/newsletter/Jan2007webnews.pdf), it is difficult to determine fair compensation if you try to pay people for their time, so we rarely think of incentives in that way. Instead, we often think of an incentive as a way to make a social compact (when provided upfront) and/or a way to help overcome a final lingering barrier to participation, whether that be braving a rainy evening to attend a focus group or spending 15 more minutes on the computer to fill out a web survey at the end of a long day.

However, a main tenet of human subject protection is to protect the voluntary nature of participation in a research project. The National Cancer Institute says “There are no clear rules or standards for payment other than a general prohibition against coercion or the exercise of undue influence. There is no agreement about whether it is right to pay research subjects.” (http://cme.cancer.gov/c01/b04_03.htm )

This issue is particularly sticky for those researchers whose studies may pose a risk to research subjects, such as medical studies, wherein the incentive could theoretically coerce someone into taking on an ill-understood risk for an immediate pay-off. Much of the research we do poses much risk, but often does incur some inconvenience or time commitment. But, we still need to be aware of the ethics surrounding the incentives we offer. We continue to think of them as something that helps a willing participant overcome hesitation about the inconvenience or time commitment of being involved in research. Moreover, I have to wonder about the quality of information we would get from an UNwilling participant whose only motivation is the incentive and not the desire to give their perspective on an issue or feedback to improve a program.