Ethical consideration of payment to patients in clinical trials

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  • 臨床研究に参加する患者に金銭を支払うことの倫理性に関する文献的研究
  • リンショウ ケンキュウ ニ サンカ スル カンジャ ニ キンセン オ シハラウ コト ノ リンリセイ ニ カンスル ブンケンテキ ケンキュウ

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The developmental process of models which Dickert and Grady suggested for the payment to research subjects was analysed, through a critical reading of their paper and a comparison with preceding papers written by Macklin and Ackerman. The wage payment model which Dickert and Grady recommended has developed for non-clinical research and was recognized as a product of compromise between competing interests ; the need to recruit subjects and obligation to offer them certain types of protection. Application of this model to clinical research causesmore ethical problems of payment as compared with its application to non-clinical research. In clinical research, furthermore, payment itself reveals more about commercial relationship between physicians and patients. However, the model has an ethical advantage to prevent therapeutic misconception. Although the reimbursement model is less likely to commercialize the patientphysician relationship, it is difficult to adopt the model as it can not prevent therapeutic misconception. Payment to patients, a symbol of clinical trials which includes tension between the obligation of society to promote research and the obligation to prevent the moral interests of patients, should be used as a tool to conduct informed consent through which both patients and physicians could attain profound realization of clinical trials together.

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