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Ethical considerations of paying Drs. to recruit for trials

Submitted by art on Fri, 2002-07-19 07:34.

bmj.com has this story that discusses the ethics of paying doctors to recruit their patients to clinical trials. Personally, it was only recently that I learned that this happened. All of a sudden my doctor wanting me to try out an experimental treatment seems a lot less about concern for my health. I'm not saying Drs. disregard their patients best interest, but the system is currently set up to run in that direction.

Paying Research Volunteers

Submitted by Margaret on Fri, 2002-07-19 09:45.
What's most interesting is that while "healthy" participants in drug research routinely receive financial compensation, it's usuaually considered unethical to pay "sick" volunteers. They are supposed to volunteer for purely altruistic reasons -- remember , you are to be promised no benefit from Phase I & 11 trials, and only possible benefit from Phase III -- while their doctors receive compensation for recruiting them. Why does this system work? Because many "sick" volunteers believe they are being compensated, by the implicit, totally wrong promise that they will benefit from the trial.
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Good Point

Submitted by chermk on Fri, 2002-07-19 16:44.
That is an excellent point! In a prior post, there was an article about all the -so called- alternative shisters out there, but there are plenty of them who work for Pharma companies and even some with M.D. behind there name. And I think those shisters are even worse, because a sick person really wants to find an answer, and who would they listen to more than their very own doctor. For the empteenth time I say, research everything and question everything before jumping in head first and brain last. And yeah, if you do decide to be in a trial, why not demand compensation. It only seems fair.
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Re:Good Point

Submitted by DaveF on Sat, 2002-07-20 16:32.
I have to disagree a bit on being paid as a patient. When we look at the cost of drugs and the cost of medical care across the board--we need to also look at ourselves to see how we contribute to the rising costs. With estimates of hundreds of millions of dollars to get a drug to market (something that should be looked into--another point for another time), the last thing we need to do is start adding to that cost and--more important--the time it takes to get a drug to the masses. The excuse that 'everyone else has their hands in the till--so I should too' doesn't fly with me. Healthy people, between jobs, or whatever need a little incentive we shouldn't need in order to be involved. I know I don't need any other incentive other than having my life as I knew it back.
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art's picture

Re:Good Point

Submitted by art on Sat, 2002-07-20 16:47.
I see your point, but I'm sure there are plenty of healthy relatives of people with diseases that would serve as controls at no cost. Also, the figures on the cost to bring a drug to market are subject to interpretation. They largely amortize all the failed attempts over the ones that succeed - so it is a little deceiving. I think we need to look at how much of that cost is discovery, how much is development, etc. but they rarely break that out in the reports. They make enough profits to pay the patients as well as the controls. Personally, I think that shouldn't have to pay either. But even worse, they sometimes don't even cover the costs of medical care if you are injured as a result of the trial!

We should start a "patient's union" and strike to not participate in trials :-)
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finding a doctor you trust

Submitted by chermk on Fri, 2002-07-19 08:45.
Just like anything else, we have to shop around for the right doctor. It took me about 6 doctors before I found one that actually listened to me and cared more about my health than other factors. I think patients should interview doctors just as they would anyone else they hire. Also, when a doctor suggests something new, it can't hurt to ask how they heard about it and why they suggest it for you. Doctor's are human too... there are ethical and moral people and mean and greedy people. It shouldn't be too difficult to figure it out.
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