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February 2, 2005

Research Compensation and the Monetarization of Medicine

JAMA. 2005;293(5):613-614. doi:10.1001/jama.293.5.613

The question of how to foster and reward research participation has 2 basic facets. One involves examining the issue from the perspective of the needs and traditions of research per se. A second facet, often neglected in discourse on the matter, is the influence of research compensation decisions on the fabric of medicine itself, particularly when it creates financial exchanges between investigators and participants. This article engages these intertwined matters.

The article by Dunn and Gordon1 draws attention to the difficult problem of recruiting research participants whose collective backgrounds mirror the population being examined. The authors maintain that the level of monetary compensation influences the participant sample created by investigators to study, which in turn requires a payment schedule that draws individuals from different income strata into given research projects. The authors do not indicate how they would determine compensation sums or convincingly deal with whether increased financial payments might exaggerate instead of diminish the overrepresentation of individuals from lower-income strata who, they argue, are disproportionately represented in many scientific studies. However, their article does point out a need to examine the generic issue of research compensation.

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