不當誘因或合理補償？淺談受試費的倫理疑慮與給付原則

Undue influence or reasonable compensation? A discussion of the practice of paying research participants and models of payment

鄭如君(Cheng, Ju-Chun)

《醫藥、科技與法律》 27卷2期 (2022/10) Pp. 121-141

摘要

本文從研究倫理與計畫執行兩個層面，來探討研究者用來提升研究參與者回應率的激勵措施與其衍生的倫理疑慮。由於激勵措施有鼓勵或影響潛在研究參與者參加研究之目的，而研究者所提供的受試費經常被視為是影響研究參與者自主權的激勵措施，因此，究竟應如何告知、何時告知，以及以什麼形式給付潛在的研究參與者才符合倫理的正當性，一直是研究倫理審查的關注重點。本文首先以英國劍橋大學研究倫理審查委員會的倫理指引，說明有關受試費的資訊揭露，如何隨著研究參與者的社經地位不同而改變其本質，並引用學者們對於及早或延遲向研究參與者揭露受試費資訊的正反觀點，來說明各方意見背後的倫理考量，同時點出「受試費」如何在不同研究情境的應用下衍生出複雜的目的性，它可能是用以鼓勵研究參與者參加研究的誘因、有時是對研究參與者的合理補償、或補貼其相對等勞力付出的工資形式等。最後，基於受試費在使用目的上的多元性，筆者認為應回歸實務應用面來評估受試費的揭露時機與使用原則，故援引Dick & Grady所整理的給付模式與給付理由，主張應從使用的目的、理由與方法來檢視倫理之正當性，才能建立一個綜合性的倫理評估架構。

關鍵字

激勵措施 ； 參與者 ； 補貼 ； 補償 ； 不當影響 ； 交換價值 ； 給付模式

並列摘要

This article examines the ethical issues of using incentives in research involving human subjects based on the ethical dimensions of offering payment to research participants and the process of implementing the protocol. Since the purpose of ＂incentives＂ is to encourage or increase potential research participants' responses to take part in research, offering payment to them is often viewed as a form of incentive that may interfere with voluntariness and the autonomy of their consent. Therefore, when to disclose offering payments and their amounts to participants in order to meet ethical standards has been the Institutional Review Board's (IRB's) focus for ethical review. This article uses the perspective of ＂Payments and Incentives in Research＂ from the Best Practice Guidance of the Central University Research Ethics Committee to explain how the meaning of offering payment to potential research participants changes from time to time according to their socioeconomic states. It has been argued by different scholars as to which practice can avoid making a tempting offer and thus having an undue influence on potential research participants' engagement. Would it be better to reveal payment amounts in recruitment materials, or to be done later through the informed consent process. However, my point is not to promote which practice is better, rather to elaborate on the positive and negative sides of both in order to represent their ethical considerations and how the purpose of ＂offering payment to participants＂ derives its diversity according to different research contexts. Payment could be an ＂incentive＂ to encourage participants to take part in research and some payments are used as a reasonable reimbursement because the participants may have travel expenses (out-of-pocket expenses) to get to the location to take part in the researcher's interview. However, some payments are used to express gratitude to participants because they may have to take a day off (a loss time and money) in order to take part in the research, and some payments can be viewed as wages because researchers ask participants to do some specific tasks (the concept is like hiring someone to do a part-time job as they may need to do a lot of work). Due to the diversity of issues, I argue that we should evaluate the principles of offering payment and the timing of disclosing the payment amounts based on the practical situations and characteristics of different research contexts. Therefore, I cite the conceptualizing payment model of Dick and Grady to explain different payment models and reasons to pay research participants in order to build a multiple ethical frame to assistant researchers in examining the purpose, reason, and model of offering payment to participants and meet their ethical justification.

並列關鍵字

incentives ； research participants ； compensation ； exchange value ； undue influence ； models of payment