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  1. Payment of COVID-19 Challenge Trials: Underpayment is a Bigger Worry Than Overpayment.Jennifer Blumenthal-Barby & Peter Ubel - 2021 - Journal of Medical Ethics 47 (8):585-586.
    One way to test vaccines is through human challenge trials in which participants are intentionally infected with a contagious organism to expedite the process of assessing the vaccine’s effectiveness. Some experts believe challenge trials may play an important role in fighting COVID-19, especially if the vaccines under current study do not demonstrate sufficient efficacy, if spread of COVID-19 is controlled to a point that radically slows down traditional trials, or if new vaccines need to be rapidly developed for specific subpopulations.1 (...)
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  • Spoonful of Honey or a Gallon of Vinegar? A Conditional COVID-19 Vaccination Policy for Front-Line Healthcare Workers.Owen M. Bradfield & Alberto Giubilini - 2021 - Journal of Medical Ethics 47 (7):467-472.
    Seven COVID-19 vaccines are now being distributed and administered around the world, with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among healthcare workers and reduce patient morbidity if properly implemented. Using the principle of (...)
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  • Promoting Ethical Payment in Human Infection Challenge Studies.Holly Fernandez Lynch, Thomas C. Darton, Jae Levy, Frank McCormick, Ubaka Ogbogu, Ruth O. Payne, Alvin E. Roth, Akilah Jefferson Shah, Thomas Smiley & Emily A. Largent - 2021 - American Journal of Bioethics 21 (3):11-31.
    To prepare for potential human infection challenge studies involving SARS-CoV-2, we convened a multidisciplinary working group to address ethical questions regarding whether and how much SAR...
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  • Good Reasons to Vaccinate: Mandatory or Payment for Risk?Julian Savulescu - 2021 - Journal of Medical Ethics 47 (2):78-85.
    Mandatory vaccination, including for COVID-19, can be ethically justified if the threat to public health is grave, the confidence in safety and effectiveness is high, the expected utility of mandatory vaccination is greater than the alternatives, and the penalties or costs for non-compliance are proportionate. I describe an algorithm for justified mandatory vaccination. Penalties or costs could include withholding of benefits, imposition of fines, provision of community service or loss of freedoms. I argue that under conditions of risk or perceived (...)
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  • Payment in Challenge Studies From an Economics Perspective.Sandro Ambuehl, Axel Ockenfels & Alvin E. Roth - 2020 - Journal of Medical Ethics 46 (12):831-832.
    We largely agree with Grimwade et al ’s1 conclusion that challenge trial participants may ethically be paid, including for risk. Here, we add further arguments, clarify some points from the perspective of economics and indicate areas where economists can support the development of a framework for ethically justifiable payment. Our arguments apply to carefully constructed and monitored controlled human infection model trials that have been appropriately reviewed and approved. Participants in medical studies perform a service. Outside the domain of research (...)
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  • Compensating for Research Risk: Permissible but Not Obligatory.Holly Fernandez Lynch & Emily A. Largent - 2020 - Journal of Medical Ethics 46 (12):827-828.
    When payment is offered for controlled human infection model research, ethical concerns may be heightened due to unfamiliarity with this study design as well as perceptions—and misperceptions—regarding risk. Against this backdrop, we commend Grimwade et al 1 for their careful handling of the relevant issues, coupling empirical and conceptual approaches. We agree with foundational elements of the authors’ analysis, including the acceptability of payment for research risk.1 However, in our view, it is preferable to treat payment for risk as a (...)
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  • On Measuring Attitudes About Payment for Research.Luke Gelinas - 2020 - Journal of Medical Ethics 46 (12):833-834.
    Significant attention has been given both to the ethics of Controlled Human Infection Model research and the ethics of payment for research participation. However, comparatively little attention has been given to the ethics of paying for participation specifically in CHIM research. Grimwade et al should be commended for thoughtfully addressing this topic and especially for the empirical data collection informing their work, which is too often lacking in discussions of payment for research participation. In what follows I will discuss three (...)
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  • Fair Go: Pay Research Participants Properly or Not at All.Olivia Grimwade, Julian Savulescu, Alberto Giubilini, Justin Oakley & Anne-Marie Nussberger - 2020 - Journal of Medical Ethics 46 (12):837-839.
    We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has traditionally been viewed as altruistic. Over time, payments for inconvenience and lost wages have been allowed, as have small incentives, usually in kind. The problem, particularly with controlled human infection model research or ‘challenge studies’, is that they are unpleasant and time-consuming. Researchers want to offer carrots to incentivise participation. We (...)
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  • Should Practice and Policy Be Revised to Allow for Risk-Proportional Payment to Human Challenge Study Participants?Euzebiusz Jamrozik & Michael J. Selgelid - 2020 - Journal of Medical Ethics 46 (12):835-836.
    Human infection challenge studies provide illuminating case studies for several ongoing debates in research ethics, including those related to research risks and payment of participants. Grimwade et al 1 add to previous public engagement, qualitative evidence and philosophical literature on these topics.1–8 The authors advocate revision of research payment policy and practice based on their main finding that members of the public endorse ex ante payment of participants proportional to research-related risk exposure, in addition to post hoc compensation for any (...)
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  • Commentary on 'Payment in Challenge Studies: Ethics, Attitudes and a New Payment for Risk Model'.Ruth Payne - 2020 - Journal of Medical Ethics 46 (12):829-830.
    Grimwade et al highlight the current lack of a universal, standardised approach to the payment of participants taking part in controlled human infection model studies.1 As they discuss, payment for these studies is controversial, with many voicing arguments for and against higher payments, particularly for those studies which involve significant burdens to the participant. The main concerns about overpayment relate to the concepts of undue inducement or coercion, whereas underpayment raises concern about exploitation and unfair treatment. In many healthy volunteer (...)
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