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A Living Wage?

Title: A Living Wage?


Author: James M. DuBois


Description:

A researcher tries to determine the appropriate amount to pay participants in a study comparing psychotherapy and pharmaceutical treatments for bipolar disorder.


Headings: Voluntariness and Undue Influence in Recruitment; Financial incentives; Mental health disorders, participants with (including addictive disorders and developmental disabilities)


Case Type: Decision Making


A Living Wage?

Dr. Johnson is a clinical psychologist and researcher at an outpatient behavioral health facility affiliated with a large medical school. Her main research interest is contrasting psychotherapeutic to pharmacological treatments of bipolar disorder. She believes that psychotherapy can be more effective than is commonly believed, and in her practice she finds that many patients seek an alternative to drug therapies that often have unwanted side effects.

She has typically recruited participants for her studies through the local chapter of a national support group for people with mental disorders and their families. However, in her most recent study almost no one responded to her recruitment poster. So she decided to make a few inquiries to find out why. She was told by several people that the group had been talking about the level of compensation studies offer. They decided that if researchers get paid for their time, participants should get paid for their time as well. They felt offended by offers to cover just their “travel expenses,” because it implies that their time is worth nothing. One person who is very active in the group said, “Look, you know many of us have trouble finding and keeping good jobs. We need the money. But that’s not the point. It’s a matter of fairness and dignity.”

Following that meeting, Dr. Johnson went to her IRB and eventually got permission to offer $15/hour for participation. Within two weeks, she nearly met her enrollment goal. At first she felt good about this approach and agreed with her participants that it was only fair that they get compensation for their time. However, she started to have second thoughts when she was explaining randomization during the informed consent process and a participant said to her, “Look boss, you put me in whatever group you think is best.” That same day she tried to obtain informed consent from another participant. But this person clearly showed no interest in learning the details of the study; instead he asked several times when they would get paid and whether he could get an advance because he’s late on his rent.


Questions

    li>Dr. Johnson is now considering whether she should go back to her IRB to change the protocol again to just cover participant’s expenses. What should she do?