Covid-19: Healthy volunteers infected for scientists’ understanding should be paid, say experts

A multidisciplinary team of international experts believes that volunteers who took part in the Covid-19 trial and get infected with the coronavirus so that scientists can understand its mechanism should be paid.

The study, published in the American Journal of Bioethics , examined the ethics of paying participants to take part in so-called 'Human Infection Challenge Studies' (HICS).

The authors of the study believe that using HICS for a disease that can be fatal and currently lacks a cure is ethically controversial. Part of that controversy has to do with whether participants should be compensated for indulging in such a risky matter and how payment might affect their consent.

The international research team from the United Kingdom (UK), United States (US), and Canada, who carried out the study, does not endorse the use of HICS for Covid-19. But if HICS proceeds, their findings reflect that not only should participants be paid, but their payment should be "substantial".

"Our work was spurred by concerns that payment for SARS-CoV-2 HICS might require a novel ethical framework, which we ultimately determined to be unfounded," states lead author Holly Fernandez Lynch, John Russell Dickson, MD Presidential Assistant Professor of Medical Ethics at the Perelman School of Medicine, University of Pennsylvania.

"Payment for HICS participation should be treated as a payment in other clinical studies involving healthy participants," she said.

"High offers of payment are sometimes met with scrutiny and concern, but it can be ethically appropriate to offer substantial payment for research participation and we have to consider that low payment also raises significant ethical concerns," she added.

Professor Fernandez Lynch, who is a lawyer and bioethics expert, stated "SARS-CoV-2 HICS should not be allowed to proceed in any setting in which there have not been adequate provisions made for compensating research-related harms, as well as other efforts to minimize risk and promote social value."

"Our hope going forward is that our analysis will serve both to ease concerns about payment in these studies, should they proceed, and to advance the broader project of ensuring ethical payment to participants in all clinical research," added Lynch.

The framework the team has developed is split into two parts. The first focuses on three main motives for payment: 'reimbursement' (for out-of-pocket expenses), 'compensation' (which includes payment for time, burden, inconvenience of isolating, etc.), and 'incentive' (to broaden the range of individuals willing to consider participation).

The second part considers appropriate compensation in the event any harm materializes - ranging from injury to death.

The report was sponsored by 1Day Sooner, an organisation pursuing Covid-19 challenge trials.

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